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Louisiana rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.18 / $8.84 / $8.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.18 / $8.84 / $9.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.13 / $7.75 / $7.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $6.38 / $8.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.81 / $8.84