go back

Georgia rates for HCPCS L1290

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.46 / $53.46 / $126.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.55 / $54.26 / $89.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.13 / $83.31 / $83.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.58 / $157.61 / $413.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.11 / $93.60 / $179.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.34 / $95.69 / $208.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.69 / $95.69 / $95.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.55 / $60.55 / $60.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.20 / $59.26 / $108.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.56 / $112.58 / $165.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.44 / $53.81 / $93.60