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Utah rates for HCPCS L1280

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

Facilitymedian $55 · 10th–90th $31–$980%20%40%10th90th$55Professionalmedian $71 · 10th–90th $31–$5620%10%10th90th$71$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
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $57.54 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $70.79 / $91.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $97.72 / $97.72
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $109.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $102.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $100.00 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $47.86 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $48.98 / $77.62