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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
$776.25 / $776.25 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $645.65 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,174.90 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $1,096.48 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $537.03 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,778.28 / $1,778.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $575.44 / $1,288.25