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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$775.50 / $958.79 / $1,052.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,509.44 / $3,389.33 / $4,012.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.76 / $932.76 / $1,559.96
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.99 / $885.47 / $1,475.79