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Pennsylvania rates for HCPCS L1220

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

Facilitymedian $288 · 10th–90th $115$4470%20%10th90th$288Professionalmedian $138 · 10th–90th $115$2240%50%10th90th$138$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $208.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $446.68 / $645.65
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $199.53 / $288.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $208.93 / $208.93
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $208.93
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $524.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $199.53 / $269.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $338.84 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $141.25 / $302.00