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Nationwide rates for HCPCS L0649

Lumbar-Sacral Orthosis Sagittal-Coronal Control With Rigid Posterior Frame/Panel(S) Posterior Extends From Sacrococcygeal Junction To T-9 Vertebra Lateral Strength Provided By Rigid Lateral Frame/Panels Produces Intracavitary Presssure To Reduce Load On Intervertebral Disc Includes Straps Closures May Include Padding Stays Shoulder Straps Pendulous Abdomen Design Prefabricated Off-The-Shelf

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.16 / $136.74 / $173.05	Facility	$130.16	$136.74	$173.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.63 / $136.74 / $197.95	Professional	$114.63	$136.74	$197.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.14 / $216.91 / $335.13	Facility	$184.14	$216.91	$335.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.20 / $193.20 / $256.69	Professional	$193.20	$193.20	$256.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $211.82 / $211.82	Facility	$211.82	$211.82	$211.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $211.82 / $218.17	Professional	$154.63	$211.82	$218.17
United Facility/Professional Professional Modifier Low / Median / High Price $115.54 / $168.24 / $263.93	Professional	$115.54	$168.24	$263.93

Nationwide rates for HCPCS L0649

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