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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
$19.70 / $19.70 / $19.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.10 / $19.70 / $20.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.28 / $28.34 / $39.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.67 / $26.92 / $28.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.80 / $87.94 / $244.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.00 / $34.97 / $41.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.21 / $84.37 / $192.31
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.00 / $33.00 / $34.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.39 / $28.34 / $131.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $14.00 / $29.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $14.05 / $29.44