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Kansas 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
$408.10 / $408.10 / $408.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.53 / $267.38 / $408.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$396.31 / $417.17 / $443.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.03 / $438.03 / $438.03
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 / $312.81 / $717.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.53 / $397.18 / $2,306.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $245.87 / $629.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $245.11 / $329.29