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Indiana rates for HCPCS L1000

Cervical-thoracic-lumbar-sacral orthosis (CTLSO) (Milwaukee), inclusive of furnishing initial orthotic, including model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,258.93 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $2,511.89 / $3,090.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $2,398.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,884.03 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,621.81 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,174.90 / $1,737.80