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Georgia rates for HCPCS L4397

Static Or Dynamic Ankle Foot Orthosis Including Soft Interface Material Adjustable For Fit For Positioning May Be Used For Minimal Ambulation Prefabricated Off-The-Shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.56 / $96.56 / $229.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.56 / $124.19 / $274.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.00 / $150.47 / $320.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.34 / $284.68 / $746.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.83 / $180.17 / $349.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.71 / $244.01 / $325.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.84 / $203.34 / $284.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.02 / $127.07 / $127.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $92.76 / $241.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.54 / $203.34 / $406.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.68 / $352.60 / $383.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.63 / $101.44 / $183.01