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Indiana rates for HCPCS L3000

Foot insert, removable, molded to patient model, UCB type, Berkeley shell, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $204.17 / $741.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $281.84 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $389.05 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $223.87 / $389.05
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $457.09 / $549.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $467.74 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $331.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $257.04 / $302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $181.97 / $257.04