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Texas rates for HCPCS L4100

Replace Leather Cuff Kafo, Proximal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.02 / $60.18 / $61.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.71 / $61.34 / $105.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.90 / $62.90 / $62.90
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.16 / $132.16 / $132.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.43 / $73.43 / $73.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $53.60 / $73.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.04 / $744.23 / $744.23
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.57 / $775.57 / $1,094.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.85 / $91.45 / $132.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.85 / $121.60 / $156.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.85 / $88.31 / $132.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $53.60 / $78.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.86 / $70.56 / $84.10
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.81 / $70.40 / $132.16