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Wisconsin rates for HCPCS L4080

Replace Metal Bands Kafo, Proximal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.38 / $60.38 / $60.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.19 / $60.38 / $108.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.70 / $131.66 / $217.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.52 / $111.32 / $147.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.11 / $256.16 / $256.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.33 / $247.64 / $499.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.56 / $173.44 / $226.54
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.70 / $90.57 / $137.66
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.52 / $119.70 / $143.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.38 / $119.70 / $593.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.56 / $67.62 / $130.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.07 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.70 / $90.57 / $137.66
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.52 / $119.70 / $143.63
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.70 / $184.21 / $341.26
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.33 / $233.78 / $593.85
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.56 / $84.33 / $667.95
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.70 / $119.70 / $119.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.70 / $119.70 / $119.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.68 / $66.33 / $106.49