go back

Utah rates for HCPCS L3209

Surgical Boot Each Child (Special Coverage Instructions Apply. See Mcm: 2079)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.71 / $23.94 / $26.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.80 / $13.71 / $22.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.60 / $27.60 / $27.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.14 / $27.60 / $28.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $45.00 / $65.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.35 / $38.08 / $48.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $18.00 / $18.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.49 / $17.32 / $20.94