go back

Kansas 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
$55.97 / $55.97 / $55.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.24 / $36.67 / $55.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.63 / $85.79 / $90.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.15 / $85.15 / $85.15
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 / $52.17 / $67.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.91 / $54.86 / $256.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.91 / $46.63 / $102.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.56 / $46.21 / $65.20