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Tennessee 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
$579.53 / $579.53 / $633.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.88 / $579.53 / $1,084.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.49 / $1,159.33 / $1,159.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$576.42 / $711.81 / $711.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.62 / $519.62 / $711.81
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,012.72 / $5,716.25 / $6,829.65
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,653.64 / $8,861.31 / $8,861.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.43 / $611.54 / $810.40