go back

New Hampshire 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
$873.32 / $873.32 / $1,047.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.30 / $677.68 / $941.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.00 / $1,551.00 / $1,838.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.90 / $929.30 / $929.30
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.78 / $1,255.78 / $3,875.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.88 / $773.78 / $1,255.78
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.65 / $1,277.82 / $1,626.31