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New Hampshire 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
$708.65 / $708.65 / $850.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.38 / $527.47 / $708.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.53 / $776.53 / $920.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.67 / $708.65 / $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 / $786.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.44 / $977.44 / $3,016.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.52 / $602.27 / $977.44
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.75 / $946.50 / $1,391.36