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Connecticut 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
$669.26 / $669.26 / $669.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.72 / $669.26 / $791.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$696.33 / $898.49 / $1,027.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.43 / $742.43 / $800.91
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 / $812.83
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$584.02 / $584.02 / $584.02
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.41 / $584.02 / $763.72
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.94 / $715.94 / $715.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.39 / $686.96 / $993.47