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Montana rates for HCPCS L0641

Lumbar Orthosis 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
$17.54 / $52.53 / $264.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.06 / $75.06 / $75.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.17 / $80.89 / $80.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.17 / $80.89 / $80.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.96 / $52.17 / $80.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.10 / $52.17 / $80.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.40 / $41.86 / $66.40