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Mississippi 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
$214.67 / $214.67 / $342.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.94 / $248.06 / $342.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.33 / $303.33 / $415.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.38 / $358.38 / $358.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.38 / $358.38 / $358.38
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $238.06 / $389.74