go back

Nevada 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
$31.58 / $31.58 / $36.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.58 / $36.44 / $81.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.96 / $53.96 / $53.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.53 / $111.80 / $173.82
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
$57.99 / $86.98 / $144.97