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New York rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.45 / $6.10 / $11.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $6.10 / $11.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.09 / $6.09 / $17.84
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.69 / $10.42 / $10.42
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.42 / $10.42 / $10.42
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 / $6.38 / $8.58
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.50 / $28.13 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $9.38 / $22.88
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $3.96 / $3.96
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.96 / $9.02 / $9.02
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $7.51 / $17.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.16 / $6.24 / $11.44
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.94 / $9.02 / $9.02
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.96 / $9.02 / $9.02