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Utah rates for HCPCS L4392

Replacement, soft interface material, static AFO

Facilitymedian $13 · 10th–90th $8–$280%20%40%10th90th$13Professionalmedian $19 · 10th–90th $8–$1170%5%10%10th90th$19$10.0$20.0$50.0$100.0

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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $15.14 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $15.85
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $20.42 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $28.18 / $28.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.95 / $30.20
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $28.18 / $28.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $28.84 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $12.59 / $13.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $12.59 / $20.89