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Minnesota rates for HCPCS L4110

Replace leather cuff KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $57.54 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $95.50 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $95.50 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $354.81 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $125.89 / $141.25
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $354.81 / $676.08
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $151.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $95.50 / $213.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $47.86 / $112.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $46.77 / $128.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $47.86 / $114.82