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Missouri rates for HCPCS L0113

Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $181.97 / $281.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $186.21 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $190.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $275.42 / $977.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $169.82 / $1,737.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $275.42 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $165.96 / $257.04