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Ohio rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.75 / $6.75 / $23.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.87 / $6.75 / $11.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $6.09 / $14.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.97 / $10.63 / $14.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.91 / $10.63 / $22.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $13.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $8.58
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $7.51 / $7.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.07 / $8.34 / $10.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.30 / $7.70