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Alaska rates for HCPCS L1260

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.85 / $96.85 / $96.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.02 / $71.02 / $71.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.84 / $71.02 / $73.15
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.45 / $27.45 / $27.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.77 / $107.41 / $169.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.45 / $27.45 / $71.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.84 / $71.02 / $105.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.65 / $84.61 / $141.02