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Mississippi 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
$89.58 / $185.73 / $296.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.11 / $188.64 / $296.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.67 / $310.72 / $310.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.83 / $256.83 / $256.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.83 / $256.83 / $256.83
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.75 / $154.19 / $246.82