go back

Colorado rates for HCPCS L0490

Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, one-piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the T-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment

Facilitymedian $339 · 10th–90th $191–$4270%20%40%10th90th$339Professionalmedian $182 · 10th–90th $145–$3020%20%40%10th90th$182$0.2$1.0$5.0$20.0$100.0$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
$190.55 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $263.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $398.11 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $354.81 / $630.96
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $354.81 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $151.36 / $354.81