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Michigan rates for HCPCS L4387

Walking boot, nonpneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.10 / $346.09 / $431.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.55 / $106.86 / $145.10
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.89 / $143.28 / $152.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.14 / $576.10 / $1,049.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.49 / $191.04 / $257.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.18 / $186.43 / $283.74
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.83 / $248.35 / $268.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.47 / $120.81 / $120.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.47 / $120.81 / $221.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.06 / $346.09 / $422.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $109.10 / $191.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.16 / $141.37 / $162.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.66 / $89.71 / $142.47