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New Jersey 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
$32.49 / $32.49 / $32.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.72 / $35.86 / $52.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.73 / $52.17 / $52.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $44.34 / $67.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.59 / $56.90 / $83.73
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.73 / $76.20 / $76.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.69 / $45.73 / $75.31