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New York 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
$31.75 / $39.89 / $73.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.13 / $39.89 / $52.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.73 / $52.76 / $103.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.80 / $53.80 / $137.32
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.12 / $66.80 / $66.80
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.80 / $66.80 / $66.80
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 / $59.30
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.73 / $116.39 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.07 / $46.60 / $93.11
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.34 / $54.34 / $54.34
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.34 / $57.95 / $61.58
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.19 / $58.19 / $58.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.73 / $52.17 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $52.17 / $80.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $45.73 / $79.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.95 / $57.95 / $57.95
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.34 / $57.95 / $61.58