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Maryland rates for HCPCS L0642

Lumbar Orthosis Sagittal Control With Rigid Anterior And Posterior Panels Posterior Extends From L-L To Below L-5 Vertebra Produces Intra- Cavitary Pressure To Reduce Load On The Inter- Vertebral Discs Includes Straps Closures May Include Padding Shoulder Straps Pendulous Abdomen Design Prefabricated Off-The-Shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.88 / $200.15 / $304.79
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.87 / $304.47 / $304.47
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 / $301.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.97 / $272.81 / $409.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.50 / $245.92 / $384.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $267.19 / $267.19