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Michigan rates for HCPCS L4370

Pneumatic full leg splint, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.94 / $161.94 / $161.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.74 / $161.94 / $161.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.22 / $855.16 / $1,557.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.39 / $283.58 / $382.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.24 / $149.01 / $184.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.86 / $226.86 / $226.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.11 / $150.11 / $150.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.82 / $150.11 / $328.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.94 / $204.93 / $204.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.31 / $204.93 / $297.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.07 / $209.85 / $241.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.42 / $130.81 / $202.97