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Utah rates for HCPCS L1200

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

Facilitymedian $1,175 · 10th–90th $562–$2,1380%20%40%10th90th$1,175Professionalmedian $1,514 · 10th–90th $562–$10,2330%10%10th90th$1,514$50.0$200.0$1.0K$5.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $1,174.90 / $10,232.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,174.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,548.82 / $1,995.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,137.96 / $2,137.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,398.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,398.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,137.96 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $870.96 / $1,698.24