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North Dakota rates for HCPCS L1250

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.22 / $59.22 / $59.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.22 / $66.20 / $66.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $89.98 / $92.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.63 / $111.73 / $140.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.53 / $66.20 / $434.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.43 / $40.61 / $67.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.07 / $40.61 / $67.68