go back

Maryland rates for HCPCS L1290

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.72 / $41.55 / $72.05
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.00 / $49.00 / $63.00
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 / $44.20 / $60.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.51 / $92.16 / $132.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $45.98 / $73.29
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.05 / $53.05 / $64.51