go back

Utah 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 $78 · 10th–90th $45–$1580%20%40%10th90th$78Professionalmedian $107 · 10th–90th $46–$6610%10%10th90th$107$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $93.33 / $660.69
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $151.36
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $158.49 / $158.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $114.82 / $173.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $158.49 / $162.18
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $70.79 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $117.49