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Oklahoma rates for HCPCS L4100

Replace leather cuff KAFO, proximal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $64.57 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $53.70 / $134.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $89.13 / $407.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $63.10 / $162.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $104.71 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $58.88 / $83.18