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Massachusetts rates for HCPCS L4090

Replace Metal Bands Kafo-Afo, Calf Or Distal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.71 / $51.71 / $51.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.71 / $51.71 / $81.95
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.50 / $220.78 / $589.04
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.24 / $80.50 / $115.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.47 / $68.47 / $203.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $68.47 / $82.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $66.72 / $118.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.83 / $95.83 / $100.62
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.72 / $67.72 / $67.72
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.74 / $589.04 / $589.04
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.30 / $59.05 / $115.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.88 / $63.26 / $115.59