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Minnesota rates for HCPCS L4392

Replacement, soft interface material, static AFO

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $15.14 / $21.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $28.18 / $41.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $28.18 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $107.15 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $38.02 / $41.69
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $104.71 / $199.53
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $44.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $28.18 / $57.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $12.59 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $12.59 / $34.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $13.80 / $34.67