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Indiana rates for HCPCS L2128

Knee Ankle Foot Orthosis Fracture Orthosis Femoral Fracture Cast Orthosis Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$956.13 / $956.13 / $1,931.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.36 / $992.91 / $1,074.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,526.12 / $1,728.96 / $1,931.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.40 / $1,148.64 / $1,585.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,448.85 / $2,124.98 / $2,897.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,642.03 / $2,124.98 / $2,607.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,207.09 / $1,207.09 / $1,931.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$881.18 / $1,207.09 / $1,981.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.50 / $963.76 / $1,423.15