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Minnesota rates for HCPCS L0638

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 Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,104.16 / $1,104.16 / $1,104.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.60 / $1,104.16 / $1,168.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,369.62 / $1,696.18 / $2,234.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,271.30 / $1,509.67 / $1,589.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,115.23 / $4,902.72 / $13,616.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,842.38 / $1,952.92 / $2,339.82
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,910.69 / $4,703.93 / $10,721.99
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,842.38 / $1,842.38 / $1,895.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.93 / $1,589.13 / $7,399.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.15 / $790.85 / $1,653.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.15 / $708.22 / $1,595.77