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Indiana rates for HCPCS L1720

Legg Perthes orthosis, trilateral, (Tachdijan type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$879.70 / $879.70 / $1,777.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.26 / $879.70 / $954.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,404.14 / $1,590.76 / $1,777.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$867.00 / $904.15 / $1,247.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,333.04 / $1,955.13 / $2,538.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,510.78 / $1,955.13 / $2,399.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,149.77 / $1,149.77 / $1,777.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.33 / $1,149.77 / $1,823.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.74 / $834.67 / $1,187.59