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Missouri rates for HCPCS L4205

Repair of orthotic device, labor component, per 15 minutes

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $14.13 / $50.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $25.12 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $22.39 / $22.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $22.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $23.44 / $158.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $14.13 / $158.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $23.44 / $30.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $14.13 / $21.88