go back

Hawaii rates for HCPCS L1030

Addition to cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, lumbar bolster pad

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $44.67 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $72.44 / $102.33
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $83.18 / $95.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $44.67 / $45.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $60.26 / $89.13