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Tennessee 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
$445.20 / $445.20 / $486.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.87 / $453.45 / $837.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.94 / $909.05 / $987.92
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,206.26 / $3,377.04 / $3,377.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,142.14 / $5,160.64 / $5,160.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.61 / $594.52 / $787.04