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Minnesota rates for HCPCS L4100

Replace Leather Cuff Kafo, Proximal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.02 / $85.02 / $85.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.20 / $85.02 / $85.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.81 / $122.36 / $170.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.89 / $116.24 / $122.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $377.61 / $1,048.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.75 / $150.26 / $180.02
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.18 / $362.30 / $825.81
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.75 / $141.75 / $146.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.99 / $122.36 / $621.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.08 / $58.63 / $136.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.08 / $58.63 / $126.03