go back

Montana rates for HCPCS L4394

Replace soft interface material, foot drop splint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.81 / $57.22 / $57.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $21.56 / $21.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.40 / $17.54 / $21.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.29 / $20.53 / $21.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.40 / $16.18 / $21.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.78 / $9.78 / $11.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $9.19 / $10.54