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Indiana rates for HCPCS L1280

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), rib gusset (elastic), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.10 / $52.10 / $105.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.10 / $52.93 / $56.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.17 / $94.23 / $105.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.73 / $58.90 / $81.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.95 / $115.81 / $148.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.49 / $115.81 / $142.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.27 / $73.27 / $105.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.49 / $73.27 / $106.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.32 / $52.05 / $73.06