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Idaho 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
Professional
Modifier
Low / Median / High Price
$190.48 / $326.23 / $423.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$303.18 / $312.81 / $312.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.35 / $228.35 / $333.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.53 / $340.51 / $483.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.07 / $459.24 / $483.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $356.75 / $424.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$423.29 / $472.08 / $708.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.39 / $351.18 / $507.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.13 / $220.78 / $340.21