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Washington rates for HCPCS L1200

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

Facilitymedian $2,399 · 10th–90th $1,585–$6,6070%20%10th90th$2,399Professionalmedian $1,585 · 10th–90th $871–$2,9510%10%20%10th90th$1,585$1.0$5.0$20.0$100.0$500.0$2.0K$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
$1,584.89 / $6,025.60 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,096.48 / $2,041.74
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,290.87 / $2,290.87
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,630.27
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,630.27 / $6,606.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,570.40 / $4,073.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $1,819.70 / $1,995.26
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $2,344.23
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,344.23 / $2,570.40
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,467.37 / $4,677.35
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,290.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,398.83 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,023.29 / $1,698.24
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $2,041.74 / $3,630.78