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Maine rates for HCPCS L0976

Lumbar-sacral orthosis (LSO), full corset

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $112.20 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $229.09 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $117.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $114.82 / $295.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $89.13 / $91.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $120.23 / $190.55