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Alabama 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
$1,630.44 / $1,630.44 / $1,630.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.80 / $1,630.44 / $1,630.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.65 / $1,118.65 / $1,118.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,037.25 / $1,037.25 / $1,776.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.19 / $1,037.25 / $1,555.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.10 / $828.14 / $1,246.24