go back

Utah rates for HCPCS L2630

Addition To Lower Extremity Pelvic Control Band And Belt Unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.85 / $89.85 / $89.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.85 / $127.02 / $1,073.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.32 / $174.32 / $174.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.25 / $174.32 / $200.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $271.54 / $353.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.70 / $363.24 / $363.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.84 / $260.37 / $390.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.97 / $139.18 / $176.59