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Utah rates for HCPCS L0635

Lumbar-Sacral Orthosis 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
$347.31 / $347.31 / $347.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.31 / $491.01 / $4,148.45
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 / $711.81 / $733.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.08 / $787.24 / $1,023.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$944.25 / $1,053.08 / $1,053.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.66 / $754.86 / $1,132.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.34 / $533.17 / $647.02