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Idaho 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
$39.86 / $79.05 / $79.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.46 / $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 / $67.77 / $90.28
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.25 / $85.77 / $90.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $66.62 / $79.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.05 / $88.16 / $132.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.20 / $63.20 / $94.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $42.52 / $67.43