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Vermont 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
Professional
Modifier
Low / Median / High Price
$19.67 / $31.60 / $36.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.89 / $38.89 / $38.89
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 / $40.67 / $51.90
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.15 / $38.15 / $42.22
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $40.67 / $73.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.54 / $38.36 / $74.87