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Rhode Island rates for HCPCS L0650

Lumbar-sacral orthosis (LSO), 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
Professional
Modifier
Low / Median / High Price
$296.82 / $657.41 / $851.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,788.74 / $1,987.49 / $2,829.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.25 / $754.41 / $986.97
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 / $812.83 / $952.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.83 / $686.96 / $1,144.94