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Utah rates for HCPCS L1260

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

Facilitymedian $48 · 10th–90th $27–$850%20%40%10th90th$48Professionalmedian $62 · 10th–90th $27–$4370%10%10th90th$62$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $51.29 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $70.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $81.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $85.11 / $85.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $95.50
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $91.20
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $87.10 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $42.66 / $50.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $42.66 / $67.61