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Nebraska rates for HCPCS L4110

Replace leather cuff KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $64.57 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $97.72 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $112.20 / $181.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $112.20 / $512.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $50.12 / $102.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $251.19
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $251.19 / $251.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $56.23 / $109.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $50.12 / $79.43