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Indiana rates for HCPCS L1907

Afo Orthosis Supramalleolar With Straps With Orwithout Interface/Pads Custom Fabricated (Revised01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.57 / $335.57 / $677.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.66 / $341.86 / $364.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.59 / $474.59 / $508.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$535.61 / $606.79 / $677.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.74 / $396.47 / $535.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.23 / $745.79 / $1,016.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.29 / $745.79 / $915.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.48 / $419.48 / $677.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.22 / $419.48 / $695.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.43 / $324.12 / $458.43