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Connecticut rates for HCPCS L1900

Ankle Foot Orthosis Spring Wire Dorsiflexion Assist Calf Band Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.91 / $173.91 / $173.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.26 / $173.91 / $181.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.32 / $357.83 / $409.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.10 / $185.10 / $193.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.91 / $189.91 / $189.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.63 / $138.63 / $189.91
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.59 / $232.59 / $232.59
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.55 / $232.59 / $304.16
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.47 / $216.47 / $216.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $178.51 / $333.77