go back

New Mexico rates for HCPCS L4394

Replace soft interface material, foot drop splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.19 / $10.19 / $10.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.19 / $15.67 / $57.22
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 / $13.40 / $13.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.65 / $20.82 / $31.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.94 / $5.94 / $15.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.40 / $23.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.10 / $9.11 / $9.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $9.19 / $13.87