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Arizona rates for HCPCS L0648

Lumbar-sacral orthosis (LSO), sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.45 / $447.90 / $871.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.00 / $202.30 / $365.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.00 / $186.66 / $372.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.68 / $758.68 / $758.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.84 / $553.84 / $882.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.06 / $322.20 / $3,377.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.76 / $551.38 / $865.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.01 / $551.38 / $865.02