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Wisconsin rates for HCPCS L4110

Replace Leather Cuff Kafo-Afo, Calf Or Distal Thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.19 / $48.19 / $48.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.37 / $48.19 / $86.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.54 / $105.09 / $173.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.98 / $88.85 / $117.51
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.73 / $204.46 / $204.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.81 / $197.92 / $398.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.12 / $138.28 / $180.81
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.77 / $72.29 / $109.87
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.70 / $95.54 / $127.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.19 / $100.32 / $510.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.28 / $55.61 / $107.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.91 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.77 / $72.29 / $109.87
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.70 / $95.54 / $127.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.54 / $147.03 / $286.05
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.81 / $186.60 / $510.12
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.12 / $61.81 / $677.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.54 / $95.54 / $95.54
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.54 / $95.54 / $95.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.72 / $50.63 / $95.54