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Michigan rates for HCPCS L1240

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

Facilitymedian $295 · 10th–90th $62–$3630%20%10th90th$295Professionalmedian $56 · 10th–90th $40–$1100%20%10th90th$56$0.1$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $295.12 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $53.70 / $75.86
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $331.13 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $114.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
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 / $63.10 / $107.15
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $229.09 / $331.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $87.10 / $134.90
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $70.79 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $89.13 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $50.12 / $72.44