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Utah rates for HCPCS L1290

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

Facilitymedian $59 · 10th–90th $28–$890%20%40%10th90th$59Professionalmedian $65 · 10th–90th $28–$5130%10%10th90th$65$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $52.48 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $60.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $83.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $89.13 / $89.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $100.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $93.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $44.67 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $70.79