go back

Washington rates for HCPCS L1220

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

Facilitymedian $302 · 10th–90th $200–$7080%20%10th90th$302Professionalmedian $204 · 10th–90th $123–$4070%20%10th90th$204$1.0$5.0$20.0$100.0$500.0$2.0K

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
$204.17 / $588.84 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $269.15
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $295.12 / $295.12
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $338.84
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $354.81 / $851.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $354.81 / $575.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $234.42 / $257.04
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $302.00
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $363.08
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $446.68 / $616.60
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $338.84 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $239.88
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $263.03 / $467.74