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Nationwide rates for HCPCS L0625

Lumbar Orthosis Flexible Provides Lumbar Support Posterior Extends From L-1 To Below L-5 Vertebra Produces Intracavitary Pressure To Reduce Load On The Intervertebral Discs Includes Straps Closures May Include Pendulous Abdomen Design Shoulder Straps Stays Prefabricated Offthe Shelf (Revised 01/01/14)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.39 / $31.73 / $44.81	Facility	$23.39	$31.73	$44.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $28.18 / $37.18	Professional	$19.67	$28.18	$37.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.36 / $41.67 / $64.37	Facility	$35.36	$41.67	$64.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $36.19 / $40.67	Professional	$34.72	$36.19	$40.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.15 / $38.15 / $42.22	Facility	$38.15	$38.15	$42.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $38.15 / $51.90	Professional	$32.43	$38.15	$51.90
United Facility/Professional Facility Modifier Low / Median / High Price $55.06 / $64.78 / $64.78	Facility	$55.06	$64.78	$64.78
United Facility/Professional Professional Modifier Low / Median / High Price $22.08 / $32.31 / $47.24	Professional	$22.08	$32.31	$47.24

Nationwide rates for HCPCS L0625

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