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Wyoming 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
Professional
Modifier
Low / Median / High Price
$285.45 / $285.45 / $645.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.90 / $494.90 / $494.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.90 / $494.90 / $494.90
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
$553.84 / $553.84 / $758.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.01 / $551.38 / $761.30