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Kansas 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
$1,323.09 / $1,323.09 / $1,323.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.65 / $866.85 / $1,323.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.53 / $1,279.30 / $1,356.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.80 / $1,269.80 / $1,269.80
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 / $2,307.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.65 / $1,287.69 / $7,517.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.75 / $797.11 / $2,041.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.29 / $797.11 / $1,067.58