search again

Nationwide rates for HCPCS L4631

Ankle-foot orthosis (AFO), walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $933.25 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $933.25 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,318.26 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,148.15 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,071.52 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $912.01 / $1,479.11