go back

Oklahoma 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
$40.74 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $50.12 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $58.88 / $295.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $44.67 / $109.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $91.20 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $42.66 / $63.10