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Washington, DC 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
$25.58 / $25.58 / $25.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.58 / $25.58 / $61.90
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.22 / $57.73 / $57.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $44.34 / $44.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.61 / $33.61 / $102.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $43.04 / $53.96