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Delaware rates for HCPCS L4055

Replace Non-Molded Calf Lacer For Custom Fabricated Orthosis Only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.95 / $123.95 / $138.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.19 / $188.19 / $188.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.38 / $137.38 / $188.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.48 / $150.25 / $226.33