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Virginia rates for HCPCS L4000

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

Facilitymedian $1,585 · 10th–90th $759$1,9950%20%40%10th90th$1,585Professionalmedian $871 · 10th–90th $631$1,4450%20%10th90th$871$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
$630.96 / $758.58 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $758.58 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,819.70
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $891.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,584.89 / $2,238.72
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,047.13 / $1,548.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,023.29 / $1,862.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,995.26
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $3,388.44
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $758.58 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $776.25 / $1,288.25