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Utah rates for HCPCS L4392

Replacement Soft Interface Material Static Afo

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.15 / $8.15 / $8.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $9.28 / $78.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.80 / $15.80 / $15.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.53 / $15.80 / $16.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.85 / $20.64 / $27.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.66 / $27.51 / $27.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.65 / $19.72 / $29.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.88 / $12.35 / $14.81