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North Carolina 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
$89.65 / $178.17 / $500.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.88 / $290.20 / $356.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.57 / $248.57 / $346.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.72 / $318.86 / $605.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.72 / $248.57 / $265.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $205.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $194.92 / $361.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.47 / $290.20 / $377.27
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.00 / $186.00 / $220.82
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.66 / $388.30 / $597.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.18 / $163.87 / $238.14
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.54 / $1,728.76 / $1,728.76
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,058.80 / $2,058.80 / $2,427.15