go back

Indiana rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.36 / $575.36 / $1,162.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$539.61 / $575.36 / $624.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.37 / $1,040.43 / $1,162.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.09 / $591.00 / $815.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.87 / $1,278.74 / $1,627.49
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.12 / $1,278.74 / $1,569.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.98 / $751.98 / $1,162.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.95 / $548.95 / $1,192.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.83 / $564.79 / $767.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.74 / $551.88 / $767.79