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New Hampshire 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
$808.30 / $808.30 / $969.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.77 / $601.65 / $808.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.49 / $898.49 / $1,065.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.43 / $742.43 / $800.91
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 / $866.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.88 / $1,114.88 / $3,441.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.98 / $686.96 / $916.07
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.94 / $1,034.52 / $1,470.33