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Louisiana 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
$109.89 / $116.65 / $157.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $116.65 / $140.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.91 / $137.91 / $144.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.97 / $302.33 / $424.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.69 / $144.36 / $144.36
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.63 / $124.63 / $124.63
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 / $234.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $96.52 / $150.53