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Washington, DC 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
$376.10 / $376.10 / $376.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.10 / $376.10 / $791.01
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.46 / $840.46 / $840.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.37 / $593.37 / $593.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.41 / $512.41 / $1,555.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.18 / $630.26 / $822.44