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Minnesota 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 / $140.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.00 / $112.90 / $146.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.21 / $202.19 / $281.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.75 / $192.08 / $202.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.07 / $623.83 / $1,732.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.38 / $248.44 / $297.66
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.36 / $598.54 / $1,364.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.38 / $234.38 / $241.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.06 / $202.19 / $939.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.25 / $100.64 / $215.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $100.64 / $209.98