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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
$50.65 / $50.65 / $55.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.10 / $50.65 / $94.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.06 / $101.32 / $101.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.34 / $60.55 / $60.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.20 / $44.20 / $60.55
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.90 / $470.06 / $560.79
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.93 / $965.57 / $965.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.82 / $52.55 / $66.54