go back

Utah rates for HCPCS L3999

Upper Limb Orthotic, Not Otherwise Specified

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $422.00 / $422.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.92 / $34.92 / $34.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00