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Colorado rates for HCPCS L1200

Thoracic-lumbar-sacral orthosis (TLSO), inclusive of furnishing initial orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.40 / $1,185.40 / $1,185.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$768.16 / $1,185.40 / $1,528.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,116.78 / $2,378.41 / $4,318.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.79 / $1,138.79 / $1,172.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,184.20 / $1,184.20 / $1,184.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.47 / $864.47 / $2,187.57
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.52 / $1,185.40 / $2,663.02
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.52 / $568.52 / $568.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,545.25 / $2,645.98 / $4,191.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.60 / $880.62 / $1,326.54