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Utah rates for HCPCS L0488

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 Transvers Planes Prefabricated Includes Fitting Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.99 / $347.99 / $347.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.99 / $403.13 / $3,405.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$782.41 / $782.41 / $782.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.16 / $782.41 / $805.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.44 / $892.65 / $1,160.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,070.69 / $1,194.09 / $1,194.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.97 / $855.93 / $1,283.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.13 / $534.22 / $633.08