go back

Montana 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
$28.84 / $48.98 / $85.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $61.66 / $75.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $69.18 / $138.04
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $69.18 / $138.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $72.44 / $112.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $75.86 / $81.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $40.74 / $44.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $35.48 / $47.86