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Arizona rates for HCPCS L4000

Replace girdle for spinal orthosis (cervical-thoracic-lumbar-sacral orthosis (CTLSO) or spinal orthosis SO)

Facilitymedian $1,549 · 10th–90th $501–$3,7150%5%10%10th90th$1,549Professionalmedian $813 · 10th–90th $631–$1,5850%20%10th90th$813$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $2,089.30 / $3,890.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,905.46 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $891.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,288.25 / $7,585.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $724.44 / $9,120.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $954.99 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $724.44 / $1,071.52