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Pennsylvania rates for HCPCS L1200

Thoracic-lumbar-sacral orthosis (TLSO), inclusive of furnishing initial orthosis only

Facilitymedian $2,138 · 10th–90th $724$4,8980%20%10th90th$2,138Professionalmedian $977 · 10th–90th $724$1,6980%20%10th90th$977$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,137.96 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $1,698.24
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,445.44 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,174.90
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,344.23 / $3,388.44
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,258.93 / $1,819.70
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $8,128.31 / $8,128.31
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,230.27 / $1,445.44
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,513.56
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $2,398.83 / $3,467.37
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,698.24
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,398.83 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $870.96 / $1,819.70