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Maine rates for HCPCS L1940

Ankle-foot orthosis (AFO), plastic or other material, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $331.13 / $1,148.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $870.96 / $1,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $371.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $645.65 / $776.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $363.08 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $275.42 / $371.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $371.54 / $645.65