go back

Utah rates for HCPCS L4010

Replace Trilateral Socket Brim

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.51 / $243.51 / $243.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.51 / $344.26 / $2,908.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.01 / $626.01 / $626.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.99 / $626.01 / $644.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.95 / $598.30 / $777.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.65 / $800.37 / $800.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.76 / $573.71 / $860.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.33 / $361.45 / $383.81