go back

Maine 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
$211.21 / $293.42 / $293.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.55 / $358.30 / $664.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.55 / $280.55 / $283.76
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.40 / $391.40 / $391.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.08 / $293.42 / $293.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.78 / $242.45 / $554.60