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Vermont 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
Professional
Modifier
Low / Median / High Price
$103.48 / $202.96 / $234.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.50 / $336.50 / $336.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $305.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $194.11 / $207.79
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $305.69
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $194.11 / $207.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.33 / $246.37 / $480.83