go back

Montana 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
$151.16 / $1,106.90 / $1,106.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.30 / $302.12 / $302.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.30 / $245.69 / $302.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.41 / $287.73 / $302.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.30 / $226.76 / $320.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.74 / $143.54 / $219.66