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Utah rates for HCPCS L3002

Foot insert, removable, molded to patient model, Plastazote or equal, each

Facilitymedian $100 · 10th–90th $55–$1950%20%40%10th90th$100Professionalmedian $135 · 10th–90th $55–$8320%10%10th90th$135$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
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $109.65 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $173.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $194.98 / $194.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $141.25 / $213.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $194.98 / $199.53
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $85.11 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $144.54