go back

South Carolina rates for HCPCS L1250

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

Facilitymedian $65 · 10th–90th $46$1380%10%20%10th90th$65Professionalmedian $52 · 10th–90th $38$950%10%20%10th90th$52$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
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $52.48 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $61.66 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $109.65
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $58.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $74.13 / $158.49
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $26.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $67.61