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Minnesota rates for HCPCS L4394

Replace Soft Interface Material, Foot Drop Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.37 / $14.37 / $14.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.56 / $14.37 / $14.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.72 / $20.68 / $28.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $19.64 / $20.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $64.14 / $178.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.00 / $25.44 / $30.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.08 / $61.54 / $140.28
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.00 / $24.00 / $24.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.12 / $20.68 / $96.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $10.22 / $21.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.95 / $9.11 / $9.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $10.22 / $20.77