go back

Connecticut rates for HCPCS L0627

Lumbar Orthosis Sagittal Control With Rigid Anterior And Posterior Panels Posterior Extends From L-1 To Below L-5 Vertebra Produces Intra- Cavitary Pressure To Reduce The Load On The Inter-Vertebral Discs Includes Straps Closures May Include Padding Shoulder Straps Pendulous Abdomen Design Prefabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.95 / $234.95 / $234.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.36 / $234.95 / $265.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$374.64 / $483.41 / $553.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.12 / $268.12 / $282.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.81 / $312.81 / $312.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.35 / $228.35 / $312.81
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.22 / $314.22 / $314.22
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.22 / $314.22 / $444.74
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.45 / $280.45 / $280.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.05 / $241.17 / $401.95