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Washington rates for HCPCS L1210

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

Facilitymedian $339 · 10th–90th $209–$6760%20%10th90th$339Professionalmedian $204 · 10th–90th $132–$4680%10%20%10th90th$204$1.0$5.0$20.0$100.0$500.0$2.0K

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
$199.53 / $524.81 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $177.83 / $263.03
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $288.40 / $288.40
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $190.55
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $416.87 / $851.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $380.19 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $223.87 / $251.19
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $309.03
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $295.12 / $309.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $436.52 / $588.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $288.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $398.11 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $158.49 / $281.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $257.04 / $446.68