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Massachusetts 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
$90.08 / $90.08 / $90.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.08 / $112.90 / $256.75
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.85 / $460.01 / $939.42
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.15 / $142.66 / $201.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.09 / $491.09 / $1,458.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.37 / $198.72 / $245.72
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.92 / $166.92 / $175.27
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.61 / $99.61 / $99.61
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.61 / $99.61 / $129.09
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.45 / $939.42 / $939.42
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.56 / $102.85 / $201.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.53 / $107.00 / $197.31