go back

Maryland rates for HCPCS L1630

Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $104.71 / $169.82
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $120.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $194.98 / $295.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $93.33 / $144.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $95.50 / $151.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $162.18