go back

Michigan rates for HCPCS L1030

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $44.67 / $64.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $281.84 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $93.33 / $100.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $52.48 / $109.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $177.83 / $199.53
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $75.86 / $114.82
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $52.48 / $56.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $75.86 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $43.65 / $63.10