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Utah rates for HCPCS L1090

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $61.66 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $81.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $81.28 / $104.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $97.72 / $169.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $79.43 / $120.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $112.20 / $114.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $114.82 / $138.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $51.29 / $69.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $51.29 / $74.13