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Massachusetts 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
$278.00 / $278.00 / $278.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.00 / $278.00 / $364.14
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.25 / $1,076.73 / $3,180.46
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $397.34 / $621.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$675.34 / $821.63 / $1,058.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.99 / $490.52 / $490.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $368.03 / $446.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $313.79 / $652.88
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.16 / $515.16 / $540.92
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.77 / $381.77 / $381.77
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.42 / $3,180.46 / $3,180.46
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.62 / $317.43 / $621.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.33 / $317.43 / $598.89