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Arizona rates for HCPCS L1240

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lumbar derotation pad

Facilitymedian $95 · 10th–90th $31–$2450%10%10th90th$95Professionalmedian $54 · 10th–90th $41–$1320%20%10th90th$54$0.1$0.5$2.0$10.0$50.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $125.89 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $63.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $77.62 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $58.88 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $43.65 / $66.07