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Utah rates for HCPCS L1686

Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $630.96 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $741.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $851.14 / $1,096.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,023.29 / $1,737.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $831.76 / $1,122.02
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,148.15 / $1,174.90
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,174.90 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $512.86 / $691.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $512.86 / $741.31