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Louisiana rates for HCPCS L0636

Lumbar-sacral orthosis (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$878.09 / $932.13 / $1,255.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.40 / $932.13 / $1,013.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,414.13 / $2,415.83 / $3,395.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$964.39 / $1,153.54 / $1,153.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.36 / $1,030.36 / $1,030.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.17 / $752.17 / $1,893.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.94 / $771.31 / $1,227.25