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Ohio rates for HCPCS L4100

Replace leather cuff KAFO, proximal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.72 / $65.72 / $220.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.56 / $65.72 / $85.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.90 / $134.60 / $348.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.00 / $68.81 / $159.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.77 / $122.36 / $168.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.53 / $114.54 / $262.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $73.43 / $152.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $53.60 / $73.43
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $73.43 / $73.43
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $73.42 / $73.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.90 / $71.36 / $93.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.70 / $59.14 / $88.32