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Louisiana 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
$106.01 / $112.53 / $151.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $109.03 / $122.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.72 / $291.64 / $409.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.07 / $116.38 / $116.38
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 / $128.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.99 / $92.11 / $137.94