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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$19.47 / $40.04 / $56.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.38 / $130.41 / $188.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.68 / $50.21 / $65.05
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 / $52.17 / $52.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.84 / $45.73 / $76.20