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Arkansas rates for HCPCS L0625

Lumbar orthosis (LO), 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, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.09 / $37.09 / $53.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.34 / $37.09 / $37.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.77 / $47.34 / $52.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.67 / $41.67 / $41.67
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.67 / $41.67 / $41.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.34 / $38.15 / $42.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $38.15 / $42.22
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.88 / $49.88 / $49.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $55.06 / $64.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $29.59 / $40.21