go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$25.58 / $34.01 / $52.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.22 / $57.73 / $57.73
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.21 / $51.73 / $77.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.40 / $46.57 / $72.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.21 / $50.66 / $53.80