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Maine rates for HCPCS L4110

Replace leather cuff KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.94 / $69.38 / $69.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.67 / $131.72 / $244.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.20 / $60.96 / $60.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.81 / $61.81 / $84.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.12 / $45.96 / $61.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.55 / $92.55 / $92.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.36 / $69.38 / $69.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $57.02 / $158.27