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North Carolina rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.31 / $9.31 / $9.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $9.31 / $9.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.67 / $14.14 / $19.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.06 / $7.97 / $7.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $7.51 / $14.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.42 / $9.31 / $12.65
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $7.00 / $7.08
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $15.00 / $23.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $5.30 / $8.84
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.75 / $110.75 / $110.75