go back

Nebraska 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
$201.83 / $201.83 / $201.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.83 / $201.83 / $262.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.16 / $305.98 / $309.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.91 / $348.14 / $348.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.91 / $348.14 / $536.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.23 / $346.43 / $1,586.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.83 / $157.88 / $263.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.12 / $348.14 / $461.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.20 / $417.24 / $717.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.83 / $157.88 / $247.71