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Utah rates for HCPCS L1220

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

Facilitymedian $166 · 10th–90th $79–$2630%20%40%10th90th$166Professionalmedian $186 · 10th–90th $79–$1,4450%10%10th90th$186$50.0$100.0$200.0$500.0$1.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $147.91 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $190.55 / $245.47
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $263.03 / $263.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $295.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $309.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $208.93