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Massachusetts rates for HCPCS L0636

Lumbar Sacral Orthosis 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
$775.50 / $775.50 / $775.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.50 / $775.50 / $1,246.01
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,588.01 / $5,056.01 / $10,110.42
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$723.14 / $1,295.67 / $1,733.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,937.98 / $2,291.94 / $2,951.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,278.43 / $1,368.29 / $1,368.29
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,437.05 / $1,437.05 / $1,508.90
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,163.95 / $1,163.95 / $1,163.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,469.88 / $10,110.42 / $10,110.42
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.68 / $885.47 / $1,733.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.99 / $948.74 / $1,700.18