go back

Maryland rates for HCPCS L1240

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.94 / $41.55 / $76.29
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.00 / $52.00 / $66.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.81 / $62.81 / $62.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.85 / $45.85 / $62.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.31 / $97.58 / $140.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.99 / $48.68 / $77.61
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.40 / $52.40 / $68.31