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Lower Extremity Orthosis Addition, Lightweight Composite

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

Rates data updated July 2026.

Facilitymedian $71 · 10th–90th $46$1580%20%40%10th90th$71Professionalmedian $93 · 10th–90th $46$6610%10%10th90th$93$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$85.11
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$89.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$117.49
Typical High
$151.36
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$158.49
Typical High
$158.49
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$114.82
Typical High
$173.78
Select Health
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Select Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$158.49
Typical High
$162.18
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$77.62
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$107.15