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Minnesota 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
$739.37 / $739.37 / $739.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.83 / $791.01 / $919.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.01 / $1,138.40 / $1,822.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.75 / $1,168.21 / $1,229.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $2,702.24 / $6,264.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.13 / $1,082.39 / $1,296.83
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,604.29 / $2,592.67 / $5,909.65
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.13 / $1,021.13 / $1,044.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.83 / $880.88 / $3,899.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.18 / $705.13 / $1,567.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.18 / $648.94 / $1,567.44