go back

Maine rates for HCPCS L2114

Ankle-foot orthosis (AFO), fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $389.05 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $912.01 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $407.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $812.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $467.74 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $323.59 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $398.11 / $691.83