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New York 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
$112.20 / $269.15 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $144.54 / $245.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $537.03
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $275.42 / $275.42
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $457.09 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $331.13
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $562.34 / $1,318.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $354.81 / $660.69
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $257.04
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $213.80 / $239.88
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $323.59 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $194.98 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $281.84
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $208.93 / $257.04
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $213.80 / $239.88