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South Carolina 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
$34.01 / $34.01 / $34.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.24 / $34.01 / $63.60
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.19 / $46.02 / $85.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.00 / $71.86 / $92.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.17 / $52.17 / $57.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $52.17 / $59.73
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.91 / $57.82 / $126.89
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.91 / $73.91 / $73.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.81 / $63.81 / $63.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.41 / $44.35 / $63.08