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Utah rates for HCPCS L2010

Knee-ankle-foot orthosis (KAFO), single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'AK' orthosis), without knee joint, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $616.60 / $6,025.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $891.25 / $1,148.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,071.52 / $1,862.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $870.96 / $1,318.26
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,230.27 / $1,412.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $524.81 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $524.81 / $741.31