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Iowa 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
$140.49 / $140.49 / $146.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.20 / $112.90 / $183.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.02 / $127.07 / $213.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.42 / $236.72 / $292.97
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.08 / $202.19 / $225.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.06 / $233.27 / $939.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.95 / $104.94 / $265.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.42 / $213.42 / $273.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.80 / $255.78 / $407.85
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.90 / $211.95 / $360.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.95 / $96.80 / $202.19
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.32 / $184.32 / $184.32
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.61 / $184.32 / $184.32