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Oregon 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
Professional
Modifier
Low / Median / High Price
$811.49 / $971.91 / $6,141.28
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 / $876.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,134.15 / $3,381.34 / $4,410.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$971.91 / $1,365.28 / $1,620.22
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,204.70 / $1,523.01 / $1,701.23
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,286.09 / $1,620.22 / $1,876.56
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.13 / $1,620.22 / $1,876.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$971.91 / $1,418.72 / $1,701.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.17 / $1,418.72 / $1,782.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,349.88 / $2,694.38 / $5,684.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.39 / $1,782.24 / $1,782.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.66 / $796.42 / $1,519.46