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Alaska rates for HCPCS L1210

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lateral thoracic extension

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.30 / $374.30 / $374.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.69 / $190.69 / $190.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.19 / $190.69 / $203.28
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.94 / $94.94 / $94.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.04 / $415.09 / $655.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.94 / $94.94 / $190.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.19 / $190.69 / $345.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.18 / $417.80 / $544.95