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Arizona rates for HCPCS L1250

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

Facilitymedian $76 · 10th–90th $26–$1950%10%10th90th$76Professionalmedian $48 · 10th–90th $37–$1620%20%10th90th$48$0.1$0.5$2.0$10.0$50.0$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
$37.15 / $48.98 / $165.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $100.00 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $91.20 / $177.83
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 / $61.66
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $64.57 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $40.74 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $40.74 / $61.66