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Georgia 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
$568.71 / $568.71 / $1,860.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$538.77 / $718.37 / $1,347.74
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.56 / $1,273.80 / $1,691.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.49 / $1,257.89 / $3,297.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.43 / $1,290.74 / $2,195.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.30 / $898.49 / $1,910.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.72 / $763.72 / $763.72
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.85 / $898.49 / $1,589.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.51 / $1,104.35 / $1,662.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.49 / $822.73 / $1,290.74