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Indiana 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 $78–$2000%20%40%10th90th$162Professionalmedian $79 · 10th–90th $68–$1290%20%10th90th$79$0.1$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $77.62 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $162.18 / $199.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $85.11 / $151.36
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $112.20