go back

Indiana rates for HCPCS L1220

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.01 / $142.01 / $286.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.03 / $142.01 / $154.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.84 / $200.84 / $200.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.67 / $256.79 / $286.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.97 / $150.94 / $208.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.15 / $311.99 / $401.69
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.88 / $315.61 / $387.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.61 / $185.61 / $286.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $185.61 / $284.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.26 / $195.26 / $195.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.01 / $136.21 / $191.72