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West Virginia 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
$489.52 / $489.52 / $489.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.21 / $489.52 / $596.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$504.74 / $988.79 / $1,358.93
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.74 / $543.57 / $931.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.68 / $758.68 / $904.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.84 / $758.68 / $3,478.06
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.24 / $793.50 / $793.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.46 / $661.41 / $1,181.08