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Montana 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

Facilitymedian $37 · 10th–90th $26–$810%20%10th90th$37Professionalmedian $29 · 10th–90th $15–$560%10%10th90th$29$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $21.88 / $47.86
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $57.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $31.62 / $56.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $31.62 / $56.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $41.69 / $72.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $57.54 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $31.62 / $37.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $29.51 / $45.71