go back

Michigan 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
$387.19 / $1,804.66 / $2,758.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.61 / $387.19 / $387.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.99 / $677.99 / $677.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,026.18 / $2,044.55 / $3,723.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.09 / $677.99 / $915.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.12 / $440.69 / $443.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.39 / $542.39 / $542.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.48 / $419.48 / $419.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$419.48 / $419.48 / $786.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.94 / $1,804.66 / $2,758.86
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.16 / $489.94 / $779.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.45 / $501.71 / $576.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.58 / $318.38 / $485.24