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Arkansas rates for HCPCS L1250

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.94 / $50.94 / $50.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.42 / $50.94 / $50.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.11 / $104.71 / $116.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.58 / $97.58 / $108.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.58 / $97.58 / $97.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.62 / $61.62 / $73.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $61.62 / $71.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.07 / $42.27 / $55.10