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Maine rates for HCPCS L1280

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

Facilitymedian $135 · 10th–90th $65–$1620%20%10th90th$135Professionalmedian $60 · 10th–90th $45–$1150%10%20%10th90th$60$50.0$100.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $56.23 / $199.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $72.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $134.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $57.54 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $47.86 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $104.71 / $112.20