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Alabama rates for HCPCS L0642

Lumbar orthosis (LO), sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.48 / $345.48 / $345.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.17 / $345.48 / $345.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.62 / $313.62 / $313.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.95 / $301.51 / $301.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.10 / $301.51 / $367.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $220.78 / $346.36