go back

New Hampshire rates for HCPCS L4394

Replace Soft Interface Material, Foot Drop Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.88 / $11.88 / $14.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.30 / $9.22 / $11.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.10 / $21.10 / $25.01
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 / $13.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $13.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.07 / $17.07 / $52.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.68 / $9.58 / $10.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $10.52 / $12.50
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.78 / $15.16 / $19.29