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New York rates for HCPCS L1290

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

Facilitymedian $71 · 10th–90th $38–$1580%10%10th90th$71Professionalmedian $55 · 10th–90th $38–$1350%20%40%10th90th$55$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$30.20 / $70.79 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $46.77 / $64.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $181.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $151.36
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $74.13 / $74.13
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $109.65
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $147.91 / $346.74
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $169.82
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $42.66
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $56.23
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $87.10 / $87.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $51.29 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $147.91
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $53.70
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $56.23