go back

Mississippi 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
$91.27 / $91.27 / $145.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.63 / $104.11 / $145.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.21 / $126.21 / $126.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.21 / $126.21 / $126.21
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 / $126.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.20 / $75.77 / $121.28