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Montana rates for HCPCS L1280

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

Facilitymedian $95 · 10th–90th $72–$1170%20%10th90th$95Professionalmedian $62 · 10th–90th $44–$1170%10%10th90th$62$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $54.95 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $102.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $186.21
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $186.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $131.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $79.43 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $54.95 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $48.98 / $74.13