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Utah rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Facilitymedian $21 · 10th–90th $11–$360%20%40%10th90th$21Professionalmedian $24 · 10th–90th $14–$520%10%20%10th90th$24$10.0$20.0$50.0$100.0

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
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $21.88 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $30.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $26.30 / $34.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $36.31 / $36.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $40.74
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $40.74
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $37.15 / $48.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $17.78 / $20.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $17.78 / $32.36