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Massachusetts 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
$915.51 / $915.51 / $915.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.51 / $915.51 / $1,284.29
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,068.00 / $3,538.28 / $11,179.36
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.48 / $1,396.66 / $2,046.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,223.98 / $2,705.72 / $3,484.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,509.24 / $1,921.17 / $1,921.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,184.20 / $1,211.99 / $1,468.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.47 / $1,184.20 / $2,499.75
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,696.50 / $1,696.50 / $1,781.32
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,243.92 / $1,243.92 / $1,243.92
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,376.92 / $11,179.36 / $11,179.36
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.85 / $1,045.33 / $2,046.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.60 / $1,047.50 / $1,765.16