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Florida 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
$676.08 / $741.31 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $794.33 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,122.02
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $977.24 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,318.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $707.95 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $776.25 / $1,023.29
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $1,621.81