go back

Utah rates for HCPCS L2192

Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $223.87 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $181.97 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $295.12 / $380.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $354.81 / $602.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $288.40 / $426.58
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $398.11 / $407.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $407.38 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $199.53 / $346.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $288.40