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Indiana 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
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $112.20 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $234.42 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $109.65 / $194.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $229.09 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $125.89 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $104.71 / $151.36