go back

New York rates for HCPCS L1280

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

Facilitymedian $72 · 10th–90th $45–$1910%10%20%10th90th$72Professionalmedian $59 · 10th–90th $45–$1450%20%40%10th90th$59$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$34.67 / $83.18 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $75.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $60.26 / $158.49
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $87.10 / $87.10
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $123.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $407.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $204.17
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $58.88
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $63.10 / $66.07
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $102.33 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $56.23 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $69.18 / $181.97
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $63.10 / $64.57
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $63.10 / $66.07