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Maine rates for HCPCS L4350

Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.19 / $146.19 / $146.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.11 / $66.53 / $71.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.05 / $134.81 / $249.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.34 / $64.27 / $64.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.22 / $68.22 / $85.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.80 / $53.18 / $68.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.73 / $94.73 / $94.73
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.19 / $146.19 / $146.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.10 / $65.87 / $71.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $58.37 / $134.21