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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$81.28 / $131.83 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $371.54 / $436.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $102.33 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $117.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $107.15 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $117.49 / $154.88