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Utah rates for HCPCS L2650

Addition To Lower Extremity Pelvic And Thoracic Control Gluteal Pad Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.54 / $43.54 / $43.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.54 / $51.44 / $434.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.36 / $112.36 / $112.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.02 / $112.36 / $115.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.19 / $98.70 / $128.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.38 / $132.03 / $132.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.18 / $94.64 / $141.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.82 / $66.84 / $81.12