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Indiana 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
$481.94 / $481.94 / $762.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.28 / $481.94 / $791.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$922.27 / $922.27 / $1,229.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.54 / $682.63 / $762.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.00 / $742.43 / $1,290.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.30 / $898.49 / $1,144.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.30 / $838.99 / $1,029.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.72 / $812.83 / $952.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.37 / $812.83 / $1,050.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.18 / $746.21 / $1,038.42