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Montana rates for HCPCS L0467

Thoracic-lumbar-sacral orthosis (TLSO), sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf

Facilitymedian $224 · 10th–90th $186–$5500%20%10th90th$224Professionalmedian $186 · 10th–90th $98–$3890%10%20%10th90th$186$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
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $389.05 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $389.05 / $389.05
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $218.78 / $549.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $218.78 / $549.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $309.03 / $426.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $245.47 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $223.87 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $208.93 / $331.13