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Missouri 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
$1,038.34 / $1,038.34 / $1,383.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.61 / $1,076.09 / $1,642.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,983.48 / $2,082.65 / $9,155.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$934.82 / $970.78 / $1,604.72
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 / $752.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.02 / $1,605.43 / $8,437.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.83 / $989.53 / $2,410.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.69 / $948.23 / $1,466.90