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Oklahoma 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
$959.92 / $959.92 / $1,414.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.37 / $959.92 / $1,060.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,777.63 / $1,777.63 / $1,777.63
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 / $1,184.20 / $1,184.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.52 / $1,258.54 / $9,758.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.08 / $967.64 / $2,007.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.08 / $880.62 / $1,263.36