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Alabama rates for HCPCS L0650

Lumbar-sacral orthosis (LSO), 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.70 / $1,045.70 / $1,045.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.91 / $791.02 / $1,045.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.56 / $955.35 / $955.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.93 / $879.93 / $879.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.72 / $812.83 / $952.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.37 / $812.83 / $1,119.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.18 / $642.71 / $1,048.10