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Maine 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
$527.47 / $732.77 / $732.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$690.65 / $894.80 / $1,658.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.67 / $700.67 / $708.65
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 / $758.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.44 / $977.44 / $977.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.65 / $732.77 / $761.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.52 / $605.51 / $1,671.60