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New Hampshire rates for HCPCS L4000

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

Facilitymedian $1,738 · 10th–90th $977$2,0890%10%20%10th90th$1,738Professionalmedian $1,148 · 10th–90th $724$1,6220%20%10th90th$1,148$500.0$1.0K$2.0K$5.0K

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
$977.24 / $977.24 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,862.09 / $2,137.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $891.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $741.31 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,023.29 / $1,513.56
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $2,454.71