go back

West Virginia rates for HCPCS L4100

Replace leather cuff KAFO, proximal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.61 / $69.61 / $69.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.50 / $65.72 / $69.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.59 / $168.44 / $235.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.16 / $94.33 / $144.28
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 / $73.43 / $639.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.13 / $67.22 / $112.04