Lumbar-sacral orthosis (LSO), 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 pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $239.88 | |
Aetna
| Professional | $114.82 | $151.36 | $239.88 | |
BCBS
| Facility | $251.19 | $251.19 | $251.19 | |
BCBS
| Professional | $251.19 | $251.19 | $251.19 | |
Cigna
| Facility | $213.80 | $213.80 | $213.80 | |
Cigna
| Professional | $154.88 | $154.88 | $213.80 | |
United
| Facility | $109.65 | $223.87 | $346.74 | |
United
| Professional | $102.33 | $165.96 | $257.04 |