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Nationwide rates for HCPCS L0637

Lumbar-Sacral Orthosis Sagittal-Coronal Control With Rigid Anterior And Posterior Frame/Panels 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 Shoulder Straps Pendulous Abdomen Design Prefabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise (Revised 01/01/14)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.66 / $826.87 / $1,084.56	Facility	$765.66	$826.87	$1,084.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $657.92 / $758.77 / $1,106.22	Professional	$657.92	$758.77	$1,106.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,263.33 / $1,499.39 / $2,577.19	Facility	$1,263.33	$1,499.39	$2,577.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $763.49 / $765.53 / $1,155.85	Professional	$763.49	$765.53	$1,155.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.54 / $906.54 / $906.54	Facility	$906.54	$906.54	$906.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $661.77 / $906.54 / $1,024.81	Professional	$661.77	$906.54	$1,024.81
United Facility/Professional Professional Modifier Low / Median / High Price $525.22 / $686.96 / $1,050.44	Professional	$525.22	$686.96	$1,050.44

Nationwide rates for HCPCS L0637

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