go back

Texas rates for HCPCS L1040

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.61 / $45.48 / $46.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.99 / $46.36 / $73.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.54 / $59.48 / $59.48
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.92 / $74.92 / $99.89
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.89 / $99.89 / $99.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.78 / $66.78 / $66.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.75 / $48.75 / $66.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.84 / $471.51 / $556.61
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.93 / $684.99 / $684.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.31 / $69.13 / $99.89
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.31 / $89.90 / $108.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.31 / $66.78 / $99.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.75 / $48.75 / $71.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.60 / $99.60 / $117.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.54 / $54.05 / $62.90
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.58 / $52.66 / $99.89