go back

Illinois rates for HCPCS L0650

Lumbar-Sacral Orthosis 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
$500.47 / $500.47 / $500.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.28 / $624.64 / $966.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$922.27 / $922.27 / $922.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,623.19 / $4,871.26 / $10,624.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.55 / $579.66 / $579.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,279.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.37 / $812.83 / $1,021.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.58 / $1,433.56 / $1,916.69
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.54 / $991.54 / $991.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.55 / $267.93 / $281.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.15 / $754.42 / $1,336.81