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Virginia 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
$76.30 / $92.18 / $92.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.30 / $92.18 / $152.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.43 / $186.43 / $197.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.34 / $112.34 / $140.43
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.04 / $124.04 / $127.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.47 / $120.81 / $120.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.19 / $88.19 / $120.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.50 / $167.79 / $223.72
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.18 / $124.98 / $192.05
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.56 / $224.00 / $310.54
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.55 / $145.93 / $211.60
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.55 / $145.93 / $211.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.71 / $93.01 / $145.93