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Hawaii rates for HCPCS L1250

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

Facilitymedian $62 · 10th–90th $40–$870%20%10th90th$62Professionalmedian $51 · 10th–90th $35–$1170%20%10th90th$51$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $102.33 / $138.04
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $112.20 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $61.66 / $120.23