go back

Wyoming 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
$345.10 / $345.10 / $345.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.34 / $188.51 / $294.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.73 / $328.73 / $328.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.73 / $328.73 / $328.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.92 / $194.92 / $343.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $142.29 / $194.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.65 / $155.62 / $172.77