go back

Arizona rates for HCPCS L1630

Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.07 / $96.19 / $170.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.52 / $196.95 / $356.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.31 / $181.74 / $247.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.29 / $119.29 / $119.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.08 / $87.08 / $295.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.48 / $144.72 / $980.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.99 / $95.24 / $143.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.99 / $95.24 / $143.46