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Idaho 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
$131.13 / $267.36 / $267.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.61 / $185.61 / $208.72
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 / $227.87 / $305.33
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.81 / $290.07 / $305.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $225.34 / $268.36
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.36 / $298.18 / $447.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.74 / $213.74 / $320.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.26 / $195.26 / $195.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.13 / $124.52 / $197.48