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North Dakota 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
$784.56 / $784.56 / $784.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.56 / $836.53 / $836.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.28 / $1,192.14 / $1,221.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,395.75 / $1,409.71 / $1,772.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.19 / $836.53 / $5,716.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.61 / $537.98 / $896.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.24 / $597.27 / $1,279.85