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Indiana rates for HCPCS L4100

Replace Leather Cuff Kafo, Proximal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.56 / $60.56 / $122.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.02 / $62.89 / $65.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.66 / $109.51 / $122.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.00 / $68.81 / $94.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.77 / $134.60 / $180.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.01 / $134.60 / $165.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $73.43 / $122.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $73.43 / $125.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.08 / $59.14 / $88.32