go back

California rates for HCPCS L1250

Addi To Thoracic-Lumbar-Sacral Orthotic (Tlso), (Low Profile), A

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.89 / $48.89 / $266.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.53 / $48.89 / $266.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.39 / $69.39 / $69.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.13 / $134.94 / $293.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.47 / $49.30 / $90.24
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.09 / $109.52 / $195.58
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $122.76 / $285.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.27 / $61.62 / $61.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $44.98 / $65.68
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.06 / $45.67 / $101.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.51 / $64.76 / $143.41
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.44 / $439.47 / $439.47
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.62 / $461.16 / $610.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.19 / $275.19 / $275.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.21 / $81.38 / $93.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $61.62 / $81.38
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.63 / $174.63 / $174.63
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.06 / $64.70 / $74.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.86 / $40.61 / $87.81