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Colorado 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
$114.30 / $114.30 / $114.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.30 / $210.36 / $288.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.11 / $229.34 / $416.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.76 / $295.79 / $306.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.51 / $301.51 / $301.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.10 / $220.10 / $353.25
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.73 / $114.30 / $510.45
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.73 / $99.73 / $99.73
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.00 / $255.14 / $408.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.82 / $220.78 / $346.36