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Oklahoma 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
$3.33 / $3.33 / $4.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $3.28 / $3.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.96 / $3.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.96 / $5.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $3.50 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $3.15 / $5.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $2.68 / $4.00