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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
$336.09 / $466.89 / $466.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$684.14 / $886.36 / $1,643.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.93 / $417.29 / $417.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.60 / $408.60 / $565.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.27 / $344.23 / $408.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.79 / $622.79 / $622.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.12 / $466.89 / $466.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.83 / $383.75 / $882.51