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New York rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.30 / $538.55 / $996.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.30 / $538.55 / $780.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.57 / $1,262.32 / $2,475.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.00 / $591.00 / $1,807.77
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$958.90 / $1,031.07 / $1,031.07
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,031.07 / $1,031.07 / $1,031.07
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 / $751.98
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $1,237.57 / $2,784.53
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.03 / $891.05 / $2,227.63
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.15 / $621.15 / $621.15
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.15 / $744.02 / $887.45
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $751.98 / $1,237.57
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.95 / $737.29 / $1,918.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.62 / $479.78 / $633.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.60 / $617.41 / $1,113.81
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$744.02 / $744.02 / $773.17
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.15 / $744.02 / $790.52