go back

Illinois rates for HCPCS L1690

Combination Bilateral Lumbo-Sacral Hip Femur Orthosis Providing Adduction And Internal Rotation Control Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,197.53 / $1,197.53 / $1,197.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$935.88 / $1,197.53 / $1,863.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,784.09 / $4,710.18 / $20,046.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,501.70 / $1,770.73 / $1,770.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.55 / $1,300.55 / $2,550.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$949.40 / $949.40 / $2,728.14
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,917.33 / $2,511.04 / $3,068.80
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,028.88 / $3,028.88 / $3,028.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.24 / $1,756.07 / $1,843.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.31 / $1,162.36 / $2,040.96