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Wyoming rates for HCPCS L1250

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.58 / $45.58 / $71.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.48 / $79.48 / $79.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.48 / $79.48 / $79.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.62 / $61.62 / $89.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.98 / $44.98 / $61.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.70 / $40.61 / $45.08