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Virginia 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
$18.07 / $32.02 / $32.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.07 / $28.18 / $32.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.67 / $41.67 / $44.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.19 / $36.19 / $45.24
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.15 / $36.15 / $36.15
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 / $32.43 / $42.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $36.56 / $58.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.10 / $36.18 / $66.70
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.83 / $60.00 / $80.06
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.45 / $46.24 / $68.66
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.45 / $46.24 / $68.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.78 / $64.78 / $77.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.86 / $32.31 / $48.67