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Utah rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Facilitymedian $631 · 10th–90th $309–$9770%20%40%10th90th$631Professionalmedian $708 · 10th–90th $309–$5,6230%10%10th90th$708$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $575.44 / $5,623.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $707.95 / $912.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $977.24 / $977.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,096.48
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,096.48
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $478.63 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $776.25