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Indiana 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
Facility
Modifier
Low / Median / High Price
$402.64 / $402.64 / $659.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.99 / $402.64 / $489.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.76 / $589.98 / $659.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.00 / $725.49 / $977.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.30 / $776.53 / $988.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.30 / $725.11 / $889.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.19 / $758.68 / $758.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.84 / $758.68 / $918.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.59 / $617.05 / $871.25