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Alabama rates for HCPCS L0455

Thoracic-lumbar-sacral orthosis (TLSO), flexible, provides trunk support, extends from sacrococcygeal junction to above T-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf

Facilitymedian $224 · 10th–90th $145–$3550%10%20%10th90th$224Professionalmedian $178 · 10th–90th $120–$2880%10%10th90th$178$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $295.12