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Utah rates for HCPCS L1250

Addi To Thoracic-Lumbar-Sacral Orthotic (Tlso), (Low Profile), A

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.21 / $26.21 / $26.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.21 / $31.59 / $266.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.62 / $61.62 / $61.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $61.62 / $65.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $59.42 / $77.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.27 / $79.48 / $79.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.26 / $56.97 / $85.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.79 / $40.61 / $51.99