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Idaho 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
$154.87 / $258.12 / $258.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.69 / $190.69 / $246.52
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 / $207.65 / $294.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.30 / $280.04 / $294.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $217.54 / $259.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.12 / $287.87 / $431.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.35 / $215.19 / $309.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.97 / $147.07 / $228.43