go back

Florida 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
$608.91 / $674.81 / $773.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.91 / $766.81 / $1,286.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.58 / $897.58 / $897.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.23 / $655.23 / $897.58
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.04 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.68 / $1,032.82 / $1,469.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.74 / $676.53 / $744.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.23 / $733.21 / $1,028.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.53 / $676.53 / $860.58