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Texas rates for HCPCS L4210

Repair Of Orthotic Device Repair Or Replace Minor Parts (Special Coverage Instructions Apply. See Mcm: 2133 2100.4 2130d)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $130.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,456.92 / $5,821.21 / $8,577.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.94 / $42.88 / $47.65
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.89 / $117.89 / $117.89
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.95 / $77.04 / $77.04
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $33.60
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.50 / $20.00 / $20.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $30.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.89 / $117.89 / $117.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.76 / $55.80 / $57.50