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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
$177.83 / $177.83 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $181.97 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $239.88 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $467.74 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $194.98 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $194.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $251.19 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $147.91 / $223.87