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Texas 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
$11.22 / $17.38 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.70 / $43.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $27.54 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,548.13 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $43.65 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $38.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $181.97 / $181.97
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $35.48 / $95.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $23.99 / $38.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $50.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $21.38 / $21.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $40.74 / $83.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $40.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $29.51 / $56.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $35.48 / $42.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74