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Florida 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
$206.32 / $228.64 / $272.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.88 / $234.95 / $335.42
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.69 / $303.33 / $303.33
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 / $315.20
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99,999.99 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.56 / $310.94 / $443.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.44 / $255.67 / $284.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.56 / $248.43 / $346.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.08 / $284.08 / $284.08