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Hawaii 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 $89 · 10th–90th $69–$1320%50%10th90th$89Professionalmedian $91 · 10th–90th $66–$1700%10%10th90th$91$100.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $79.43 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $154.88 / $208.93
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $177.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $169.82 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $181.97