go back

Utah rates for HCPCS L2020

Knee-ankle-foot orthosis (KAFO), double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'AK' orthosis), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $724.44 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $891.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $954.99 / $1,258.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,148.15 / $1,995.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $933.25 / $1,513.56
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,318.26 / $1,778.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $660.69 / $1,348.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $933.25