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Iowa rates for HCPCS L4360

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.74 / $216.74 / $244.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.88 / $187.35 / $298.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $343.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.92 / $361.50 / $451.88
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.72 / $337.28 / $371.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.96 / $391.19 / $1,620.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.13 / $175.82 / $426.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.13 / $343.13 / $473.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.95 / $405.52 / $655.73
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.94 / $334.09 / $567.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.13 / $155.88 / $405.52
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.33 / $296.33 / $296.33
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.11 / $296.33 / $296.33