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Georgia rates for HCPCS L0643

Lumbar-Sacral Orthosis 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 Pendulousabdomen Design Prefabricated Off-The-Shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $221.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.97 / $82.89 / $109.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.50 / $171.50 / $449.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.25 / $158.02 / $271.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.39 / $122.50 / $239.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.13 / $104.13 / $104.13
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 / $94.02 / $139.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.88 / $122.50 / $233.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.20 / $150.57 / $226.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.23 / $97.86 / $153.53