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Minnesota 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
$78.95 / $78.95 / $78.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.22 / $75.05 / $78.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.34 / $113.64 / $158.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.91 / $107.96 / $113.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.02 / $350.71 / $974.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.63 / $139.52 / $167.16
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.21 / $336.49 / $766.99
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.63 / $131.63 / $135.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.27 / $113.64 / $457.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.34 / $47.48 / $114.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.29 / $79.43 / $182.46