go back

Iowa rates for HCPCS L1250

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

Facilitymedian $87 · 10th–90th $46$2450%20%10th90th$87Professionalmedian $51 · 10th–90th $39$980%20%10th90th$51$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
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $51.29 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $109.65 / $138.04
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $104.71 / $112.20
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $104.71 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $52.48 / $134.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $93.33 / $123.03
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $83.18 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $40.74 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $79.43