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West Virginia 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
$96.32 / $96.32 / $96.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.79 / $96.32 / $114.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.43 / $223.72 / $286.56
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.50 / $230.46 / $432.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.47 / $120.81 / $225.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.19 / $120.81 / $916.14
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.50 / $125.90 / $130.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.14 / $100.18 / $155.02