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Colorado 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
$330.29 / $330.29 / $330.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.29 / $791.01 / $903.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.79 / $662.70 / $1,203.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.43 / $742.43 / $1,290.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $952.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.37 / $593.37 / $1,021.13
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.18 / $330.29 / $1,285.41
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.18 / $288.18 / $288.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.55 / $737.25 / $1,179.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.27 / $630.26 / $988.78