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Utah rates for HCPCS L3214

Benesch Boot Pair Junior (Special Coverage Instructions Apply. See Mcm: 2079)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.36 / $26.36 / $26.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.51 / $26.36 / $43.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.68 / $49.68 / $49.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.27 / $49.68 / $51.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $45.00 / $80.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.27 / $72.36 / $92.72
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.33 / $55.33 / $55.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.80 / $32.92 / $40.15