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Hawaii rates for HCPCS L1100

Addition to cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, ring flange, plastic or leather

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $120.23 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $234.42 / $331.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $281.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $269.15 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $112.20 / $114.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $181.97 / $288.40