go back

New Jersey 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
$171.39 / $171.39 / $171.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.10 / $189.17 / $277.08
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.20 / $362.20 / $362.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.81 / $301.51 / $301.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.10 / $220.10 / $353.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.99 / $300.08 / $441.62
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.81 / $401.95 / $401.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.50 / $241.17 / $397.17