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Tennessee 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
$50.12 / $54.95 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $50.12 / $97.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $67.61 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $89.13
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 / $60.26
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $43.65 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $52.48 / $66.07