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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$53.80 / $53.80 / $64.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.24 / $40.04 / $53.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.96 / $58.96 / $69.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.20 / $53.80 / $53.80
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 / $55.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.20 / $74.20 / $229.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $45.73 / $60.97
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.88 / $65.87 / $83.83