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Ohio 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
$74.47 / $278.95 / $491.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.38 / $179.00 / $284.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.47 / $233.96 / $276.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.91 / $343.13 / $889.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.16 / $174.99 / $415.92
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.14 / $265.14 / $265.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.72 / $343.13 / $463.31
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.96 / $389.93 / $546.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $398.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $142.29 / $194.92
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.53 / $194.92 / $194.92
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $194.92 / $194.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.32 / $181.95 / $238.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.75 / $155.62 / $226.15