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North Dakota 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
$69.20 / $69.20 / $69.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.03 / $52.53 / $69.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.04 / $63.90 / $65.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.13 / $67.80 / $85.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.78 / $57.80 / $256.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.90 / $48.04 / $76.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.72 / $46.48 / $75.79