go back

Rhode Island 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
Professional
Modifier
Low / Median / High Price
$842.83 / $996.99 / $1,144.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,727.31 / $3,683.60 / $4,360.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.85 / $1,303.36 / $1,744.40
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 / $1,037.25 / $1,037.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.88 / $1,020.92 / $1,603.92