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Minnesota 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
$344.09 / $344.09 / $344.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.08 / $265.79 / $344.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.82 / $528.59 / $696.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.18 / $470.47 / $495.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.81 / $1,528.03 / $4,243.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.13 / $608.57 / $729.14
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.17 / $1,466.07 / $3,341.71
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.13 / $574.13 / $590.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.81 / $495.23 / $2,306.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $246.91 / $497.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.19 / $246.54 / $497.29