go back

Utah rates for HCPCS L2265

Addition to lower extremity, long tongue stirrup

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $79.43 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $112.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $97.72 / $123.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $117.49 / $199.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $95.50 / $141.25
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $131.83 / $134.90
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $134.90 / $162.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $66.07 / $870.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $66.07 / $95.50