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Minnesota rates for HCPCS L4387

Walking Boot Non-Pneumatic With Or Without Joints With Or Without Interface Material Prefabricated Off-The-Shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.88 / $132.74 / $132.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.18 / $108.15 / $155.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.65 / $191.04 / $266.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.83 / $181.49 / $191.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.81 / $589.69 / $1,637.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.63 / $234.92 / $281.45
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.09 / $565.78 / $1,289.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.63 / $221.63 / $228.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.98 / $191.04 / $889.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.97 / $100.24 / $229.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.76 / $91.33 / $191.83