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Alaska rates for HCPCS L1220

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.20 / $326.20 / $326.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.61 / $185.61 / $185.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $185.61 / $197.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.38 / $80.38 / $80.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.07 / $361.75 / $571.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.38 / $80.38 / $185.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $197.87 / $316.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.05 / $364.12 / $474.95