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New York rates for HCPCS L4000

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

Facilitymedian $1,096 · 10th–90th $631$2,6300%20%10th90th$1,096Professionalmedian $871 · 10th–90th $631$2,1380%20%10th90th$871$1.0$10.0$100.0$1.0K$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
$489.78 / $1,148.15 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $758.58 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $2,951.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $2,454.71
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,202.26 / $1,202.26
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,862.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,398.83 / $5,623.41
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $2,818.38
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $691.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $912.01
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,412.54 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $831.76 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $954.99 / $2,454.71
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $870.96
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $912.01