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Montana rates for HCPCS L1250

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

Facilitymedian $79 · 10th–90th $58–$1000%20%40%10th90th$79Professionalmedian $51 · 10th–90th $31–$930%10%10th90th$51$50.0$100.0$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
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $50.12 / $74.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $85.11 / $85.11
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $154.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $154.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $79.43 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $45.71 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $40.74 / $61.66