Alright, so i changed the macro to this now

/target [mod:shift] iceorbs
/target [mod:ctrl] Orbzem
/target [mod:alt] Orbzz
/target [mod:ctrl,mod:alt] Orbzm
/cast Lesser Healing Wave

and that works...

I dont know why the hell /cast [mod:ctrl, target=Orbzem] Lesser Healing Wave would not....