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Idaho 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
$33.88 / $33.88 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $32.36 / $35.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $53.70 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $38.02
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $33.88 / $48.98
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $26.92 / $33.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $45.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $39.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $19.50 / $56.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $28.18 / $54.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $31.62 / $34.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $29.51 / $43.65