go back

Washington rates for HCPCS L1240

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

Facilitymedian $95 · 10th–90th $63$2040%10%20%10th90th$95Professionalmedian $63 · 10th–90th $44$1410%10%10th90th$63$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $147.91 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $95.50
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $91.20 / $91.20
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $104.71
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $123.03 / $263.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $114.82 / $204.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $72.44 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $91.20 / $93.33
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $93.33 / $97.72
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $138.04 / $186.21
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $91.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $120.23 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $83.18
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $81.28 / $144.54