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Idaho 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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.53 / $177.50 / $177.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.82 / $211.82 / $211.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.63 / $211.82 / $218.17
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.56 / $113.25 / $186.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.99 / $128.15 / $142.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $204.47 / $242.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.24 / $138.24 / $267.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.67 / $103.94 / $149.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.97 / $154.02 / $244.27