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Mississippi 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
$1,013.09 / $1,013.09 / $1,614.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.99 / $1,155.55 / $1,614.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,355.84 / $1,355.84 / $1,446.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.67 / $1,720.67 / $1,720.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,720.67 / $1,720.67 / $1,720.67
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.10 / $882.18 / $1,357.20