go back

Utah rates for HCPCS L4110

Replace Leather Cuff Kafo-Afo, Calf Or Distal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.77 / $30.77 / $30.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.77 / $43.50 / $367.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.81 / $61.81 / $61.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.12 / $61.81 / $65.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.97 / $70.67 / $91.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.76 / $94.53 / $94.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.83 / $67.76 / $101.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.03 / $47.66 / $55.98