go back

Arizona rates for HCPCS L1290

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lateral trochanteric pad

Facilitymedian $95 · 10th–90th $31–$2630%10%10th90th$95Professionalmedian $51 · 10th–90th $40–$1320%20%10th90th$51$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $128.82 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $60.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $79.43 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $44.67 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $95.50 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $66.07