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North Dakota 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
$1,365.28 / $1,365.28 / $1,365.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,135.03 / $1,135.03 / $1,365.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,754.59 / $2,074.54 / $2,126.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,893.75 / $1,912.69 / $2,405.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$754.00 / $1,365.28 / $8,437.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.13 / $884.18 / $1,495.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.94 / $884.18 / $1,495.18