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New Jersey 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
$600.91 / $600.91 / $600.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.91 / $803.73 / $1,158.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,037.53 / $1,184.20 / $1,765.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.47 / $864.47 / $1,545.64
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,612.61 / $1,623.95 / $2,312.36
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,680.11 / $1,765.16 / $1,765.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.13 / $880.62 / $1,620.51