go back

Maine 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
$120.23 / $147.91 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $295.12 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $186.21
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $263.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $162.18 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $123.03 / $194.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $154.88 / $257.04