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West Virginia 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
$177.83 / $467.74 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $186.21 / $416.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $436.52 / $575.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $501.19 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $1,659.59
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $81.28 / $131.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $234.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $186.21 / $288.40