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South Carolina 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
$447.90 / $447.90 / $447.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.90 / $447.90 / $837.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.00 / $527.49 / $1,137.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.68 / $758.68 / $837.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.84 / $758.68 / $786.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.06 / $761.43 / $1,671.33
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.32 / $973.32 / $973.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.33 / $840.33 / $840.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.61 / $597.33 / $859.23