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Washington rates for HCPCS L1290

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

Facilitymedian $102 · 10th–90th $62$2510%10%10th90th$102Professionalmedian $62 · 10th–90th $42$1410%10%10th90th$62$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $213.80 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $97.72
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $89.13 / $89.13
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $102.33
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $125.89 / $257.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $114.82 / $204.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $69.18 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $91.20
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $89.13 / $91.20
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $131.83 / $181.97
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $89.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $131.83 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $85.11
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $138.04