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Tennessee 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
$112.29 / $112.29 / $122.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.21 / $122.68 / $210.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.69 / $224.63 / $224.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.41 / $185.61 / $185.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $135.50 / $185.61
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.03 / $1,347.14 / $1,580.75
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,673.42 / $1,713.56 / $2,495.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.26 / $195.26 / $195.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.01 / $121.91 / $178.63