go back

New Jersey 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
$528.01 / $528.01 / $528.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.01 / $674.97 / $853.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,115.23 / $1,115.23 / $1,551.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$814.12 / $814.12 / $1,358.11
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,416.96 / $1,426.92 / $2,031.81
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.27 / $1,551.00 / $1,551.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.05 / $773.78 / $1,423.90