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Utah rates for HCPCS L1240

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

Facilitymedian $56 · 10th–90th $28$870%20%40%10th90th$56Professionalmedian $63 · 10th–90th $28$5010%10%10th90th$63$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $52.48 / $501.19
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $83.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $87.10 / $87.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $97.72
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $95.50
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $43.65 / $70.79