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Utah rates for HCPCS L4210

Repair of orthotic device, repair or replace minor parts

Facilitymedian $20 · 10th–90th $20–$200%50%100%$20Professionalmedian $22 · 10th–90th $20–$2750%20%40%10th90th$22$10.0$20.0$50.0$100.0$200.0

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
$19.95 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $21.88 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $31.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $16.98 / $44.67
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29