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Maine rates for HCPCS L1250

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

Facilitymedian $100 · 10th–90th $46$1200%20%10th90th$100Professionalmedian $51 · 10th–90th $40$850%10%20%10th90th$51$50.0$100.0$200.0$500.0

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
$39.81 / $51.29 / $144.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $61.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $100.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $39.81 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $81.28 / $83.18