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Florida 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
$811.19 / $898.97 / $1,029.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.45 / $946.28 / $1,714.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.61 / $1,468.40 / $1,468.40
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 / $1,364.80
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$678.16 / $1,202.32 / $1,202.32
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.17 / $1,211.00 / $1,957.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.57 / $728.57 / $801.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.13 / $968.05 / $1,263.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.57 / $728.57 / $1,057.58