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Maryland 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
$13.16 / $26.07 / $33.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.07 / $24.04 / $35.61
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.15 / $36.15 / $36.15
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 / $40.67
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $36.56 / $54.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.07 / $32.31 / $51.13
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $35.53 / $36.19