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Maryland rates for HCPCS L4370

Pneumatic Full Leg Splint Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.83 / $104.38 / $174.52
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.00 / $123.00 / $156.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.11 / $150.11 / $150.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.58 / $109.58 / $150.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.47 / $229.24 / $330.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.37 / $114.37 / $182.31
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.42 / $127.42 / $160.47