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Rhode Island 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 $575 · 10th–90th $234$8320%20%10th90th$575Professionalmedian $178 · 10th–90th $141$3390%20%10th90th$178$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$177.83
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$602.56
Typical High
$831.76
BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$223.87
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$234.42
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$323.59