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Connecticut rates for HCPCS L1620

Hip Orthosis Abduction Control Of Hip Joints Flexible (Pavlik Harness) 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
$86.30 / $86.30 / $86.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.05 / $86.30 / $90.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.62 / $177.58 / $203.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.06 / $94.06 / $96.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.36 / $117.36 / $126.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $85.67 / $117.36
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.43 / $115.43 / $115.43
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.56 / $115.43 / $153.66
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.47 / $103.47 / $103.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $88.59 / $165.65