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Utah rates for HCPCS L1610

Hip Orthosis Abduction Control Of Hip Joints Flexible (Frejka Cover Only) Prefabricated Item That Has Been Trimmed Bent Molded Assembled Orotherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $15.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.93 / $22.52 / $190.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.91 / $30.91 / $30.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.56 / $30.91 / $31.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.61 / $36.11 / $47.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.31 / $48.30 / $48.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.50 / $34.61 / $51.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.32 / $24.67 / $24.67