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Wisconsin rates for HCPCS L1040

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

Facilitymedian $110 · 10th–90th $87$2000%50%10th90th$110Professionalmedian $65 · 10th–90th $45$1620%20%10th90th$65$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $74.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $251.19 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $154.88 / $204.17
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $134.90
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $173.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $107.15 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $58.88 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $123.03 / $213.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $275.42
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $218.78 / $562.34
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $97.72 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $53.70 / $89.13