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Idaho 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
Professional
Modifier
Low / Median / High Price
$36.44 / $100.24 / $100.24
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 / $128.79 / $137.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.29 / $63.96 / $105.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.56 / $72.37 / $80.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $115.48 / $137.21
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.06 / $78.06 / $151.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.29 / $58.70 / $84.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.88 / $86.21 / $137.94