go back

New Jersey 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
$30.14 / $30.14 / $30.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.14 / $41.10 / $53.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $60.55 / $88.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.20 / $44.20 / $77.54
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.89 / $81.47 / $116.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.47 / $88.55 / $88.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.35 / $118.06 / $141.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $45.55 / $81.29