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Arizona 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
$12.64 / $17.48 / $31.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.72 / $32.75 / $69.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.39 / $51.99 / $94.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.97 / $47.96 / $65.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $38.15 / $38.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $32.43 / $51.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.10 / $39.29 / $181.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.07 / $29.59 / $44.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.71 / $29.59 / $44.57