go back

South Carolina rates for HCPCS L1210

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $158.49 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $295.12 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $190.55 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $338.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $177.83 / $194.98
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $234.42 / $467.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $95.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $181.97 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $147.91 / $194.98