go back

Louisiana 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
$820.44 / $870.93 / $1,173.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.11 / $870.93 / $946.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.29 / $2,257.23 / $3,172.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.07 / $1,077.80 / $1,077.80
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $1,845.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.75 / $716.63 / $1,104.31