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Washington rates for HCPCS L1260

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

Facilitymedian $91 · 10th–90th $60$2090%10%10th90th$91Professionalmedian $62 · 10th–90th $41$1380%10%10th90th$62$1.0$5.0$20.0$100.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $144.54 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $97.72
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $89.13 / $89.13
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $102.33
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $120.23 / $257.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $112.20 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $69.18 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $91.20
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $91.20 / $91.20
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $131.83 / $181.97
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $89.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $114.82 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $45.71 / $81.28
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $77.62 / $138.04