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Montana rates for HCPCS L4398

Foot Drop Splint Recumbent Positioning Device Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.20 / $54.83 / $257.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.28 / $90.28 / $90.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.56 / $97.07 / $97.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.56 / $78.94 / $97.07
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.27 / $92.45 / $97.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.56 / $72.86 / $97.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.43 / $41.41 / $47.41