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Maryland 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
$197.85 / $236.48 / $377.89
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.86 / $269.86 / $330.46
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.39 / $483.41 / $696.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.54 / $241.17 / $384.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $265.13 / $338.39