go back

Michigan rates for HCPCS L1700

Legg Perthes orthosis, (Toronto type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,070.54 / $1,070.54 / $1,070.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.80 / $1,070.54 / $1,070.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,837.25 / $5,652.89 / $10,295.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,780.82 / $1,874.55 / $2,530.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,118.28 / $1,218.46 / $1,266.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,499.64 / $1,499.64 / $1,499.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,212.63 / $1,212.63 / $1,212.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.63 / $1,212.63 / $2,173.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,070.54 / $1,354.64 / $1,354.64
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,070.54 / $1,354.64 / $1,968.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,137.47 / $1,387.17 / $1,595.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.04 / $880.30 / $1,409.06