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Missouri rates for HCPCS L1630

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

Facilitymedian $170 · 10th–90th $107–$5130%20%10th90th$170Professionalmedian $117 · 10th–90th $83–$1780%20%10th90th$117$0.2$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
$109.65 / $109.65 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $117.49 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $120.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $169.82 / $977.24
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $158.49