go back

South Dakota rates for HCPCS L0648

Lumbar-Sacral Orthosis 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
$619.52 / $619.52 / $619.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.16 / $692.12 / $761.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.68 / $758.68 / $1,104.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.75 / $891.58 / $1,103.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.18 / $1,169.68 / $3,377.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.16 / $833.44 / $1,311.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,104.04 / $1,125.75 / $1,505.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.33 / $1,225.85 / $2,322.06
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.13 / $856.54 / $1,045.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.49 / $761.30 / $1,004.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.60 / $983.60 / $983.60