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North Dakota 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
$52.13 / $244.91 / $244.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.34 / $187.34 / $244.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.74 / $372.13 / $381.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.50 / $365.12 / $459.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.40 / $244.91 / $1,620.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.69 / $172.77 / $319.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.85 / $181.56 / $311.94