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Vermont 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
$235.89 / $235.89 / $272.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.10 / $391.10 / $391.10
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 / $367.55
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.81 / $312.81 / $312.81
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.35 / $312.81 / $367.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.21 / $286.33 / $558.82