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Maine rates for HCPCS L4394

Replace Soft Interface Material, Foot Drop Splint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.66 / $12.80 / $12.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.77 / $24.31 / $45.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.78 / $11.78 / $11.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $13.40 / $15.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $13.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.07 / $17.07 / $17.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $12.80 / $12.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $9.11 / $9.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.10 / $10.52 / $24.20