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Missouri rates for HCPCS L1720

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.83 / $912.83 / $1,216.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.83 / $946.02 / $1,443.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.71 / $1,830.90 / $8,048.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$869.33 / $904.15 / $1,410.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,149.77 / $1,149.77 / $1,149.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.33 / $839.33 / $1,184.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$827.66 / $1,411.37 / $7,860.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.60 / $869.92 / $2,119.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.94 / $864.05 / $1,385.39