search again

Nationwide rates for HCPCS L0643

Lumbar-sacral orthosis (LSO), sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.51 / $77.23 / $97.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.73 / $77.23 / $111.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.99 / $122.50 / $189.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.25 / $111.80 / $146.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.79 / $128.79 / $128.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.02 / $124.17 / $137.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.23 / $95.02 / $144.97