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Washington, DC rates for HCPCS L4631

Ankle Foot Orthosis 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
$767.46 / $767.46 / $767.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.46 / $767.46 / $996.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,041.75 / $1,041.75 / $1,281.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.19 / $757.19 / $757.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,218.83 / $1,218.83 / $3,722.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.66 / $935.48 / $1,405.56