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Michigan 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
$556.08 / $556.08 / $556.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.82 / $556.08 / $822.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$922.27 / $922.27 / $922.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.43 / $2,300.06 / $4,189.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.58 / $762.72 / $1,029.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$495.77 / $495.77 / $584.02
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$610.17 / $610.17 / $610.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $952.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,297.86
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.08 / $1,004.58 / $1,004.58
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.08 / $791.01 / $1,045.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$773.47 / $909.97 / $1,046.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.95 / $733.00 / $1,067.88