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North Dakota 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
$365.00 / $365.00 / $365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.79 / $265.79 / $365.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.08 / $554.62 / $568.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.13 / $579.87 / $729.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.08 / $365.00 / $2,306.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.87 / $245.11 / $399.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.87 / $220.78 / $399.73