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Indiana rates for HCPCS L1990

Ankle Foot Orthosis Double Upright Free Plantar Dorsiflexion Solid Stirrup Calf Band/Cuff (Double Bar Bk Orthosis) Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.67 / $278.67 / $563.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.83 / $278.67 / $302.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.80 / $503.92 / $563.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.67 / $308.99 / $426.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.28 / $619.34 / $796.86
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.58 / $619.34 / $760.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $313.79 / $563.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $313.79 / $577.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.02 / $268.37 / $377.47