go back

Nevada 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 $631 · 10th–90th $68–$6460%50%10th90th$631Professionalmedian $174 · 10th–90th $98–$2950%5%10%10th90th$174$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $630.96 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $169.82 / $234.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $186.21 / $295.12