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Alaska rates for HCPCS L1250

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

Facilitymedian $56 · 10th–90th $26–$1000%20%40%10th90th$56Professionalmedian $58 · 10th–90th $44–$1410%10%20%10th90th$58$50.0$100.0$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
$43.65 / $51.29 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $120.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $77.62 / $100.00
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $100.00 / $263.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $104.71
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $104.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $93.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $61.66 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $61.66 / $257.04