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Indiana rates for HCPCS A5113

Leg Strap; Latex Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $4.80 / $5.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.70 / $4.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.80 / $2.80 / $5.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $2.80 / $3.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.75 / $6.15 / $8.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $6.15 / $7.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $3.96 / $3.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.96 / $5.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $2.80 / $4.21