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West Virginia 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
$109.65 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $102.33 / $158.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $245.47
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $323.59 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $120.23 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $114.82 / $177.83