go back

Massachusetts rates for HCPCS L4350

Ankle Control Orthosis Stirrup Style Rigid Includes Any Type Interface (E.G. Pneumatic Gel)Prefabricated Off-The-Shelf (Revised 01/01/14) D 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.33 / $51.11 / $116.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.82 / $60.49 / $108.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.30 / $264.33 / $637.78
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.70 / $79.68 / $114.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.18 / $151.07 / $194.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.68 / $103.81 / $135.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.66 / $68.22 / $82.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.80 / $68.22 / $119.79
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.73 / $94.73 / $99.47
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.74 / $60.74 / $60.74
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.27 / $60.74 / $62.82
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.33 / $637.78 / $637.78
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.87 / $58.37 / $114.25
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.65 / $91.31 / $91.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.58 / $59.76 / $100.70