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North Dakota rates for HCPCS L4050

Replace Molded Calf Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.39 / $338.39 / $338.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.39 / $344.26 / $344.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.87 / $514.16 / $526.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.50 / $580.25 / $729.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.85 / $344.26 / $2,531.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.29 / $232.04 / $386.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.69 / $257.61 / $552.02