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Minnesota rates for HCPCS L4090

Replace Metal Bands Kafo-Afo, Calf Or Distal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.76 / $70.76 / $70.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.94 / $70.76 / $81.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.24 / $101.84 / $141.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.47 / $96.75 / $101.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $314.50 / $873.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.13 / $125.21 / $150.02
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.72 / $301.75 / $687.80
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.13 / $118.13 / $121.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.74 / $101.84 / $538.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.84 / $50.75 / $122.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.84 / $53.44 / $211.44