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North Carolina rates for HCPCS L4210

Repair of orthotic device, repair or replace minor parts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $22.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.92 / $89.36 / $89.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.38 / $117.89 / $117.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $35.34
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.34 / $35.34 / $35.34
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $100.00