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Utah 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 $26 · 10th–90th $19–$360%20%40%10th90th$26Professionalmedian $28 · 10th–90th $15–$790%10%20%10th90th$28$10.0$20.0$50.0$100.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $33.11 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $38.02
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.79 / $54.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $27.54 / $36.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $38.90
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $28.18 / $56.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $28.18 / $41.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $29.51 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $28.18 / $41.69