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Louisiana 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
$168.59 / $178.97 / $241.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.95 / $178.97 / $206.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.08 / $311.94 / $311.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.51 / $463.83 / $651.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.16 / $221.48 / $221.48
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.91 / $207.91 / $207.91
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 / $184.69 / $194.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.75 / $148.09 / $239.81