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California 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
$24.31 / $35.61 / $186.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.44 / $35.61 / $69.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.08 / $32.01 / $77.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.38 / $36.19 / $37.72
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.01 / $95.50 / $136.91
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $68.61 / $163.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $38.15 / $51.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $32.43 / $47.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.52 / $34.61 / $41.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.85 / $37.25 / $82.49
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.98 / $181.21 / $181.21
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.95 / $276.89 / $276.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.34 / $117.34 / $117.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.36 / $19.10 / $44.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.78 / $32.43 / $42.22
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.23 / $122.23 / $122.23
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.69 / $34.61 / $45.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $64.78 / $64.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.07 / $29.59 / $58.39