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Nebraska 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
$56.47 / $56.47 / $56.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.47 / $56.47 / $73.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.27 / $75.27 / $75.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.81 / $85.60 / $86.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.55 / $97.41 / $97.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.55 / $97.41 / $150.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.90 / $96.92 / $470.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.71 / $44.18 / $91.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.12 / $97.41 / $134.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.19 / $115.28 / $200.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.35 / $100.35 / $100.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.03 / $44.18 / $66.48