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Colorado rates for HCPCS L0638

Lumbar-sacral orthosis (LSO), 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, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.67 / $899.67 / $899.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.66 / $899.67 / $1,203.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,606.56 / $1,805.13 / $3,277.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$929.30 / $929.30 / $1,003.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,115.23 / $1,115.23 / $1,115.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$814.12 / $814.12 / $1,692.04
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.21 / $873.45 / $2,134.76
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.21 / $457.21 / $457.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.79 / $2,008.20 / $3,180.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.05 / $708.22 / $1,066.83