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West Virginia 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
$37.02 / $37.02 / $37.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.51 / $35.43 / $37.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.34 / $107.51 / $129.01
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.59 / $64.50 / $114.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.95 / $52.95 / $111.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.65 / $52.95 / $388.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.52 / $38.31 / $59.86