go back

Wyoming 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
$21.67 / $21.67 / $49.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.58 / $37.58 / $37.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.58 / $37.58 / $37.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.17 / $52.17 / $83.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $44.34 / $52.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.40 / $41.86 / $46.48