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Utah rates for HCPCS L2415

Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint

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 / $77.62 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $87.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $107.15 / $141.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $128.82 / $223.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $104.71 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $147.91 / $151.36
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $151.36 / $173.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $64.57 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $64.57 / $93.33