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Minnesota 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
$1,498.13 / $1,498.13 / $1,498.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.97 / $1,498.13 / $1,540.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,847.01 / $2,156.12 / $3,002.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,724.90 / $2,048.31 / $2,156.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,184.20 / $6,652.16 / $18,475.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,499.75 / $2,649.74 / $3,174.68
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,949.31 / $6,382.42 / $14,547.88
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,499.75 / $2,499.75 / $2,572.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$585.58 / $2,156.12 / $9,758.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.08 / $985.22 / $2,165.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.08 / $985.22 / $2,165.14