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Tennessee 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
$224.04 / $224.04 / $244.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.21 / $236.48 / $367.17
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.13 / $257.13 / $497.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.69 / $448.17 / $448.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.38 / $312.81 / $312.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.35 / $228.35 / $312.81
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$778.08 / $2,306.87 / $2,306.87
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,498.42 / $2,498.42 / $3,625.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.62 / $239.18 / $332.57