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New Mexico 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
$47.66 / $47.66 / $47.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.66 / $73.19 / $373.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.23 / $77.64 / $92.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.27 / $73.27 / $73.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.49 / $73.27 / $73.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.75 / $97.19 / $145.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.30 / $31.30 / $73.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.49 / $73.27 / $113.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.02 / $48.49 / $73.03