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Utah rates for HCPCS L2630

Addition to lower extremity, pelvic control, band and belt, unilateral

Facilitymedian $174 · 10th–90th $89–$3720%20%40%10th90th$174Professionalmedian $209 · 10th–90th $89–$1,6220%10%10th90th$209$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $194.98 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $269.15 / $354.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $371.54 / $371.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $331.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $371.54 / $380.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $380.19 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $138.04 / $275.42