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Pennsylvania rates for HCPCS L1630

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

Facilitymedian $219 · 10th–90th $78–$3020%20%40%10th90th$219Professionalmedian $102 · 10th–90th $78–$1780%20%10th90th$102$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$77.62 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $97.72 / $173.78
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $120.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $371.54
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $134.90 / $194.98
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $102.33 / $169.82
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $263.03 / $380.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $181.97
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $257.04 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $194.98