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Nebraska rates for HCPCS L1250

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

Facilitymedian $89 · 10th–90th $40–$4370%20%10th90th$89Professionalmedian $51 · 10th–90th $28–$2190%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $51.29 / $398.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $109.65 / $154.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $91.20 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $40.74 / $85.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $218.78
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $204.17 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $40.74 / $63.10