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Utah rates for HCPCS L1290

Addi To Thoracic-Lumbar-Sacral Orthotic (Tlso), (Low Profile), L

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.52 / $28.52 / $28.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.52 / $39.54 / $340.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.55 / $60.55 / $60.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.20 / $60.55 / $64.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.22 / $64.64 / $84.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.54 / $86.47 / $86.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.24 / $61.99 / $92.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.59 / $44.18 / $56.56