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Missouri rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.07 / $571.07 / $760.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.07 / $591.84 / $903.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,090.88 / $1,145.42 / $5,035.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.23 / $591.00 / $882.56
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 / $548.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541.00 / $882.97 / $5,145.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.08 / $544.23 / $1,325.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.00 / $484.10 / $872.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.05 / $544.23 / $806.77