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Mississippi rates for HCPCS L4000

Replace girdle for spinal orthosis (cervical-thoracic-lumbar-sacral orthosis (CTLSO) or spinal orthosis SO)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.62 / $823.62 / $1,312.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.62 / $939.44 / $1,312.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,138.89 / $1,138.89 / $1,138.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.89 / $1,138.89 / $1,138.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.58 / $897.58 / $897.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.23 / $655.23 / $1,347.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.75 / $697.72 / $1,159.74