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Connecticut rates for HCPCS L0641

Lumbar orthosis (LO), sagittal control, with rigid posterior panel(s), posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.55 / $44.55 / $44.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.40 / $40.04 / $52.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.69 / $58.96 / $67.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.20 / $53.80 / $53.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.17 / $52.17 / $52.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $44.34 / $52.17
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.32 / $38.32 / $38.32
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.61 / $38.32 / $50.12
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.94 / $45.94 / $45.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.84 / $45.73 / $65.50