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Maryland 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
$115.26 / $115.90 / $218.55
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.00 / $151.00 / $192.51
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 / $135.50 / $185.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.13 / $281.61 / $405.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.26 / $195.26 / $195.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.40 / $140.49 / $223.94
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.53 / $149.53 / $197.13