go back

New Jersey rates for HCPCS L1630

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $95.50 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $120.23 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $120.23
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $204.17 / $281.84
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $125.89 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $95.50 / $158.49