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North Dakota rates for HCPCS L4040

Replace Molded Thigh Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.26 / $349.26 / $349.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.60 / $347.60 / $349.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.85 / $530.70 / $543.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.13 / $585.92 / $736.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.41 / $349.26 / $2,469.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.25 / $239.49 / $382.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.94 / $239.49 / $382.49