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Missouri rates for HCPCS L0635

Lumbar-sacral orthosis (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$631.26 / $631.26 / $841.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.79 / $654.22 / $998.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,205.84 / $1,266.14 / $5,566.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.47 / $656.78 / $991.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.81 / $711.81 / $711.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.62 / $519.62 / $733.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.22 / $976.03 / $5,716.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.72 / $601.58 / $1,465.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.72 / $601.58 / $900.67