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Georgia rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$490.59 / $490.59 / $1,165.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.59 / $586.42 / $820.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,033.05 / $1,446.27 / $3,791.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$550.76 / $858.96 / $1,649.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$878.09 / $988.12 / $1,911.14
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$878.09 / $878.09 / $878.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.98 / $751.98 / $751.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.95 / $548.95 / $1,347.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.12 / $1,033.05 / $1,762.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.39 / $479.78 / $537.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.58 / $515.38 / $850.29