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Utah rates for HCPCS L2030

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.58 / $367.58 / $367.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.58 / $515.28 / $4,390.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.15 / $713.15 / $713.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.60 / $713.14 / $760.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.55 / $833.16 / $1,083.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$999.35 / $1,114.53 / $1,114.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.66 / $798.90 / $1,198.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.81 / $569.38 / $729.03