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Minnesota rates for HCPCS L4000

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

Facilitymedian $1,738 · 10th–90th $1,096–$11,7490%20%40%10th90th$1,738Professionalmedian $1,585 · 10th–90th $794–$1,8620%50%10th90th$1,585$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,584.89 / $2,089.30
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $6,025.60 / $14,125.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,041.74 / $2,344.23
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $5,888.44 / $11,748.98
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,584.89 / $7,585.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $707.95 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $831.76 / $2,238.72