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Arkansas rates for HCPCS L1260

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.25 / $51.25 / $51.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.09 / $51.25 / $51.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.59 / $105.35 / $117.05
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.64 / $99.64 / $111.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.64 / $99.64 / $99.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.02 / $71.02 / $73.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.84 / $71.02 / $72.03
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.82 / $84.82 / $84.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.34 / $42.88 / $61.61