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Montana rates for HCPCS L1290

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

Facilitymedian $87 · 10th–90th $59–$1070%20%10th90th$87Professionalmedian $55 · 10th–90th $40–$1020%10%20%10th90th$55$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $48.98 / $79.43
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $93.33 / $93.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $169.82
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $169.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $81.28 / $120.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $50.12 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $44.67 / $67.61