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Delaware 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
Professional
Modifier
Low / Median / High Price
$771.71 / $771.71 / $853.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,037.25 / $1,037.25 / $1,037.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.19 / $757.19 / $1,037.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,875.14 / $1,875.14 / $1,875.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$844.66 / $935.48 / $1,407.77