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New Hampshire rates for HCPCS L1210

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

Facilitymedian $302 · 10th–90th $166–$3550%10%20%10th90th$302Professionalmedian $219 · 10th–90th $145–$2750%20%10th90th$219$100.0$200.0$500.0$1.0K

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
$165.96 / $165.96 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $323.59 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $190.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $257.04
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $426.58