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Iowa rates for HCPCS L1220

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

Facilitymedian $263 · 10th–90th $148–$7590%20%10th90th$263Professionalmedian $155 · 10th–90th $110–$2880%20%10th90th$155$0.2$1.0$5.0$20.0$100.0$500.0

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
$162.18 / $162.18 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $331.13 / $416.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $331.13 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $436.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $295.12 / $380.19
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $436.52 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $263.03 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $128.82 / $245.47
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $251.19