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Utah rates for HCPCS L1951

Ankle foot orthosis (AFO), spiral, (Institute of Rehabilitative Medicine-type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $537.03 / $4,265.80
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 / $831.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $741.31 / $954.99
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $891.25 / $1,548.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $724.44 / $1,047.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,023.29 / $1,047.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,047.13 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $446.68 / $512.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $446.68 / $645.65