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Indiana 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
$154.88 / $229.09 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $186.21 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $234.42 / $251.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $316.23 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $190.55 / $331.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $389.05 / $467.74
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $389.05 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $194.98 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $275.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $218.78 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $229.09