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Nationwide rates for HCPCS L0650

Lumbar-Sacral Orthosis Sagittal-Coronal Control With Rigid Anterior And Posterior Frame/Panel(S) Posterior Extends From Sacrococcygeal Junction To T-9 Vertebra Lateral Strength Provided By Rigid Lateral Frame/Panel(S) Produces Intracavitary Pressure To Reduce Load On Intervertebral Discs Includes Straps Closures May Include Padding 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 $549.16 / $601.65 / $817.94	Facility	$549.16	$601.65	$817.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $447.92 / $700.52 / $870.12	Professional	$447.92	$700.52	$870.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $739.45 / $898.49 / $1,388.15	Facility	$739.45	$898.49	$1,388.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $742.43 / $742.43 / $1,257.01	Professional	$742.43	$742.43	$1,257.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $952.31	Facility	$812.83	$812.83	$952.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $593.37 / $812.83 / $952.31	Professional	$593.37	$812.83	$952.31
United Facility/Professional Professional Modifier Low / Median / High Price $494.39 / $692.15 / $1,050.44	Professional	$494.39	$692.15	$1,050.44

Nationwide rates for HCPCS L0650

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