go back

Nebraska 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
Facility
Modifier
Low / Median / High Price
$231.18 / $231.18 / $231.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.18 / $231.18 / $300.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.62 / $350.48 / $354.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.30 / $398.77 / $398.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.30 / $398.77 / $614.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.21 / $393.01 / $1,533.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.31 / $180.86 / $301.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.61 / $398.77 / $502.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.58 / $465.82 / $821.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.08 / $326.08 / $326.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.57 / $171.82 / $231.56