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Washington rates for HCPCS L1630

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

Facilitymedian $204 · 10th–90th $138–$5010%20%10th90th$204Professionalmedian $138 · 10th–90th $85–$3020%10%20%10th90th$138$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
$138.04 / $138.04 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $181.97
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $199.53
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $120.23
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $269.15 / $575.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $251.19 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $141.25 / $173.78
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $204.17
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $204.17 / $204.17
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $302.00 / $416.87
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $199.53
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $257.04 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $102.33 / $181.97
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $177.83 / $316.23