go back

Idaho rates for HCPCS L1250

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.45 / $74.87 / $74.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.02 / $61.62 / $61.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $61.62 / $65.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.21 / $64.20 / $85.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.95 / $81.23 / $85.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $63.09 / $75.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.87 / $83.50 / $125.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.85 / $59.85 / $89.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.54 / $40.61 / $64.40