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Colorado rates for HCPCS L4000

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,584.89 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $912.01 / $1,318.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,862.09 / $3,548.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $870.96 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $933.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,659.59 / $2,344.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,659.59 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $776.25 / $891.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $724.44 / $1,071.52