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Minnesota rates for HCPCS L0625

Lumbar Orthosis 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 Offthe Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.24 / $33.24 / $33.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.67 / $33.24 / $48.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.98 / $50.01 / $77.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.22 / $51.32 / $54.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $125.18 / $347.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.25 / $50.09 / $60.01
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.31 / $120.10 / $273.76
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.25 / $47.25 / $48.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.67 / $40.85 / $181.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $33.04 / $66.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $64.78 / $77.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $33.04 / $66.65