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Vermont 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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.96 / $671.96 / $796.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.54 / $906.54 / $906.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.77 / $906.54 / $1,048.83
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.54 / $906.54 / $906.54
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.77 / $906.54 / $1,048.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.98 / $815.68 / $1,591.86