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New Mexico rates for HCPCS L4000

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

Facilitymedian $1,096 · 10th–90th $468–$1,7380%10%10th90th$1,096Professionalmedian $794 · 10th–90th $676–$1,3180%20%10th90th$794$100.0$200.0$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
$741.31 / $741.31 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $794.33 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $2,290.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,096.48 / $1,737.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $776.25 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $724.44 / $1,071.52