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Rhode Island rates for HCPCS L4360

Walking Boot Pneumatic And/Or Vacuum With Or Without Joints With Or Without Interface Materialprefabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.48 / $181.73 / $246.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.04 / $794.24 / $940.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.19 / $234.19 / $376.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $240.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $184.69 / $194.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.30 / $207.50 / $345.83