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Michigan rates for HCPCS L4392

Replacement Soft Interface Material Static Afo

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.19 / $16.19 / $16.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.04 / $16.19 / $16.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.89 / $85.46 / $155.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $28.34 / $38.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $18.42 / $18.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.67 / $22.67 / $22.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.80 / $15.80 / $15.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.80 / $15.80 / $33.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.19 / $20.48 / $20.48
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.19 / $20.48 / $29.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.19 / $20.97 / $24.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.51 / $13.55 / $19.30