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Delaware 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
$5.27 / $5.27 / $5.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.10 / $19.18 / $24.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $38.15 / $42.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $32.43 / $51.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.86 / $32.31 / $43.80