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Connecticut rates for HCPCS L4360

Walking Boot Pneumatic And/Or Vacuum With Or Without Joints With Or Without Interface Materialprefabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.20 / $99.03 / $202.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.83 / $187.34 / $202.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.33 / $415.92 / $475.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.42 / $189.42 / $199.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $194.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $142.29 / $194.92
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.35 / $270.35 / $270.35
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.35 / $270.35 / $320.26
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.70 / $210.56 / $375.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.30 / $207.50 / $345.83