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New Jersey 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
$22.05 / $22.05 / $22.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.18 / $25.35 / $35.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.56 / $38.15 / $42.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $32.43 / $63.70
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.64 / $40.22 / $59.17
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.56 / $53.85 / $53.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $64.78 / $77.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.27 / $32.31 / $53.22