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Vermont rates for HCPCS L1250

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

Facilitymedian $51 · 10th–90th $40–$690%20%10th90th$51Professionalmedian $46 · 10th–90th $44–$620%20%10th90th$46$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $45.71 / $52.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $61.66
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $41.69 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $61.66 / $109.65