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Michigan rates for HCPCS L1290

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

Facilitymedian $257 · 10th–90th $52–$3090%50%10th90th$257Professionalmedian $52 · 10th–90th $39–$950%20%10th90th$52$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
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $257.04 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $52.48 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $281.84 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $97.72
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
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 / $60.26 / $109.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $194.98 / $281.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $75.86 / $114.82
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $64.57 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $75.86 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $67.61