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North Dakota 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
$48.93 / $48.93 / $48.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.24 / $35.61 / $48.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.20 / $45.16 / $46.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.25 / $47.72 / $60.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.91 / $40.85 / $181.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.79 / $32.84 / $53.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.73 / $77.73 / $77.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.77 / $29.59 / $53.58