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North Carolina rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$904.57 / $904.57 / $1,560.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.04 / $904.57 / $904.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.24 / $993.89 / $1,887.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $774.79 / $774.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$639.03 / $751.98 / $751.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.22 / $548.95 / $1,347.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.52 / $904.57 / $1,175.94
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.00 / $581.00 / $702.41
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,485.10 / $1,485.10 / $2,283.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.00 / $479.78 / $633.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.31 / $510.78 / $747.30
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,856.36 / $6,145.65 / $6,145.65
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,210.34 / $6,210.34 / $9,281.78