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Nebraska rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.35 / $10.35 / $10.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.35 / $10.35 / $13.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.99 / $12.09 / $12.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $11.69 / $13.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.51 / $13.66 / $21.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.68 / $12.50 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.16 / $6.24 / $10.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.69 / $13.71 / $17.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.26 / $15.21 / $26.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.16 / $6.19 / $8.17