go back

Vermont rates for HCPCS L1220

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $147.91 / $181.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $199.53
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $245.47 / $331.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $154.88 / $194.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $186.21 / $524.81