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Nevada 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
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $794.33 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,122.02 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,122.02
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,584.89 / $2,754.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,584.89 / $1,621.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $707.95 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $891.25 / $1,445.44