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Maine rates for HCPCS L1110

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.36 / $206.11 / $206.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $391.27 / $725.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.24 / $183.61 / $183.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.30 / $225.30 / $249.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.47 / $164.47 / $225.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.93 / $274.93 / $274.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.19 / $206.11 / $206.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.94 / $170.75 / $389.57