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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$283.75 / $283.75 / $340.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.28 / $211.21 / $283.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.94 / $310.94 / $368.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.55 / $283.76 / $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 / $314.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.40 / $391.40 / $1,208.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.78 / $241.17 / $321.58
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.83 / $379.00 / $557.12