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Montana rates for HCPCS L0482

Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, one-piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated

Facilitymedian $2,188 · 10th–90th $1,380–$2,6920%20%10th90th$2,188Professionalmedian $1,288 · 10th–90th $708–$2,5700%10%10th90th$1,288$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$707.95 / $1,148.15 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,344.23 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,344.23 / $2,344.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $4,265.80
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $4,265.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $2,041.74 / $2,570.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,737.80 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,096.48 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $870.96 / $1,348.96