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Oklahoma rates for HCPCS L1755

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.39 / $843.39 / $1,243.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.16 / $843.39 / $990.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,395.53 / $1,395.53 / $1,395.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.74 / $1,018.74 / $2,500.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.47 / $1,105.76 / $9,370.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.24 / $889.85 / $1,764.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.24 / $852.71 / $1,276.59