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Mississippi rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,071.52 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $1,445.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,479.11 / $2,398.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $891.25 / $1,348.96