go back

New York 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
$109.65 / $263.03 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $234.42 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $562.34
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $269.15 / $269.15
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $549.54 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $346.74
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $549.54 / $1,258.93
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $380.19 / $630.96
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $208.93 / $234.42
Fidelis
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $263.03 / $263.03
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $316.23 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $194.98 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $169.82 / $281.84
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $194.98 / $204.17
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $208.93