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Georgia 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 $162 · 10th–90th $76–$5890%20%10th90th$162Professionalmedian $89 · 10th–90th $69–$1580%20%10th90th$89$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
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $204.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $380.19 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $199.53
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
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 / $194.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $69.18 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $154.88