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Minnesota rates for HCPCS L1250

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

Facilitymedian $105 · 10th–90th $66–$6920%20%10th90th$105Professionalmedian $95 · 10th–90th $48–$1100%50%10th90th$95$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $95.50 / $123.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $95.50 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $354.81 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $141.25
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $354.81 / $691.83
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $95.50 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $40.74 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.65 / $39.81 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $134.90