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Indiana rates for HCPCS L1250

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

Facilitymedian $98 · 10th–90th $47–$1200%50%10th90th$98Professionalmedian $49 · 10th–90th $41–$760%50%10th90th$49$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
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $47.86 / $67.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $97.72 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $51.29 / $97.72
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $46.77 / $67.61