go back

Idaho rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.81 / $945.29 / $945.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.98 / $751.98 / $811.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.95 / $548.95 / $1,018.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.52 / $810.47 / $1,079.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$971.60 / $1,025.57 / $1,079.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $796.71 / $948.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$945.29 / $1,054.25 / $1,581.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.69 / $755.69 / $1,133.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $559.49 / $633.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.59 / $484.10 / $767.79