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Mississippi 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
$724.44 / $724.44 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $707.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $1,023.29 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $616.60 / $870.96