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Arizona rates for HCPCS L2755

Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only

Facilitymedian $126 · 10th–90th $46–$3160%10%10th90th$126Professionalmedian $81 · 10th–90th $65–$1410%20%10th90th$81$0.1$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $165.96 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $151.36 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $89.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $107.15 / $741.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $70.79 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $104.71