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Iowa rates for HCPCS L4100

Replace leather cuff KAFO, proximal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $64.57 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $141.25 / $177.83
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $141.25 / $151.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $154.88 / $616.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $77.62 / $208.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $141.25 / $177.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $208.93 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $79.43 / $190.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $61.66 / $114.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $117.49 / $117.49