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Maine 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
$89.13 / $114.82 / $331.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $257.04 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $112.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $229.09
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $117.49 / $331.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $89.13 / $120.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $109.65 / $194.98