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Oklahoma 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
$23.34 / $36.78 / $569.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.48 / $23.33 / $23.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.23 / $43.23 / $43.23
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 / $38.15 / $51.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.10 / $37.90 / $181.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $31.81 / $59.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $55.06 / $55.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $30.10 / $42.45