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Rhode Island rates for HCPCS L1920

Ankle Foot Orthosis Single Upright With Static Or Adjustable Stop (Phelps Or Perlstein Type) Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.71 / $236.55 / $310.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.10 / $999.59 / $1,183.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.89 / $341.89 / $473.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.11 / $246.11 / $302.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.66 / $246.10 / $246.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.41 / $261.14 / $435.25