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Pennsylvania rates for HCPCS L4394

Replace soft interface material, foot drop splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.30 / $8.30 / $32.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.90 / $9.22 / $11.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.37 / $20.18 / $20.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $13.40 / $20.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $17.67
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.57 / $20.18 / $38.34
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.30 / $8.30 / $32.11
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.90 / $9.53 / $13.01
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $28.80 / $39.79
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.40 / $13.40 / $20.18
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $24.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.42 / $19.21 / $19.21
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.42 / $19.21 / $19.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.10 / $9.11 / $13.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.62 / $10.17 / $17.63