go back

Nebraska 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
$169.82 / $169.82 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $257.04 / $776.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $234.42 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $302.00 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $194.98 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $363.08 / $602.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $354.81 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $436.52 / $776.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $346.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $602.56 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $181.97 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $245.47