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New Jersey rates for HCPCS L4100

Replace Leather Cuff Kafo, Proximal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.70 / $49.70 / $49.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.70 / $61.34 / $70.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $73.43 / $145.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $53.60 / $127.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.37 / $134.29 / $191.22
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.82 / $138.94 / $145.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.15 / $72.83 / $134.02