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Indiana rates for HCPCS L4110

Replace leather cuff KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.28 / $47.28 / $95.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.21 / $49.10 / $52.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.48 / $85.51 / $95.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.61 / $57.20 / $78.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.66 / $105.09 / $143.31
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.20 / $105.09 / $128.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.81 / $61.81 / $95.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.12 / $61.81 / $98.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.78 / $47.66 / $68.38