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North Carolina 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
$218.55 / $218.55 / $377.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.26 / $218.55 / $218.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.10 / $240.12 / $455.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.27 / $187.19 / $187.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.38 / $185.61 / $185.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $185.61 / $332.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.38 / $218.55 / $285.27
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.00 / $140.00 / $169.70
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.20 / $398.20 / $614.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.26 / $195.26 / $195.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.67 / $124.52 / $187.56
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.19 / $1,580.75 / $1,580.75
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.56 / $1,713.56 / $2,495.92