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Kentucky 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
$821.19 / $851.61 / $851.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.81 / $821.19 / $853.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$994.58 / $1,597.72 / $1,679.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.29 / $831.29 / $929.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,198.29 / $2,224.78 / $2,559.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.83 / $1,986.41 / $2,636.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,115.23 / $1,115.23 / $1,872.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$814.12 / $1,115.23 / $7,621.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.39 / $1,067.55 / $1,334.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.39 / $789.97 / $1,083.77