go back

Missouri 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
$303.45 / $303.45 / $404.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.39 / $314.48 / $480.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.65 / $608.63 / $2,675.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.16 / $308.99 / $468.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $313.79 / $313.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $229.07 / $334.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.41 / $467.15 / $2,738.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.56 / $289.18 / $704.56
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.00 / $462.00 / $462.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.56 / $289.18 / $419.08