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Utah rates for HCPCS L3630

Transfer Of An Orthosis From One Shoe To Another Solid Stirrup New (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.83 / $34.83 / $34.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.83 / $54.35 / $340.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.56 / $67.56 / $67.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.33 / $67.56 / $72.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.60 / $89.35 / $116.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.17 / $119.52 / $119.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.06 / $85.67 / $128.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $53.95 / $63.36