go back

Illinois rates for HCPCS L4000

Replace Girdle For Spinal Orthotic (Cervic-Thoracic-Lumbar-Sacor

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.32 / $818.32 / $818.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.26 / $818.32 / $1,273.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,901.64 / $3,217.24 / $13,699.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.58 / $897.58 / $1,757.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.23 / $655.23 / $1,864.21
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,273.70 / $1,630.38 / $1,974.24
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
$2,069.77 / $2,069.77 / $2,069.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.99 / $1,199.99 / $1,259.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.19 / $794.29 / $1,363.53