go back

Mississippi 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
$84.57 / $84.57 / $134.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.57 / $107.47 / $136.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.18 / $141.18 / $141.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.18 / $141.18 / $141.18
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 / $128.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.99 / $94.81 / $153.53