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Montana rates for HCPCS L2114

Ankle Foot Orthosis Fracture Orthosis Tibial Fracture Orthosis Semi-Rigid Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.55 / $2,515.58 / $2,515.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.82 / $643.82 / $643.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.60 / $692.23 / $692.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.60 / $562.92 / $692.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.57 / $659.27 / $692.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.60 / $519.54 / $692.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.85 / $326.23 / $499.22