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Hawaii 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
Professional
Modifier
Low / Median / High Price
$19.05 / $28.18 / $33.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $54.95 / $77.62
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $66.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $63.10 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $29.51 / $37.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $48.98 / $67.61