go back

Mississippi 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
$895.37 / $895.37 / $1,427.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.48 / $1,021.28 / $1,427.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,238.10 / $1,238.10 / $1,238.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.10 / $1,238.10 / $1,238.10
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 / $1,115.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.15 / $758.50 / $1,262.05