go back

Utah rates for HCPCS L8415

Prosthetic Sheath Upper Limb Each (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.27 / $8.27 / $8.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.27 / $9.31 / $82.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.91 / $16.30 / $17.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $20.81 / $28.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.88 / $27.74 / $27.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.79 / $19.89 / $29.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $12.83 / $18.41