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Michigan rates for HCPCS L3001

Foot Insert Removable Molded To Patient Model Spenco Each (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.01 / $91.01 / $91.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.59 / $91.01 / $91.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.22 / $480.60 / $875.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.40 / $159.37 / $215.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.11 / $103.59 / $104.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.96 / $88.96 / $88.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.81 / $88.96 / $184.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.01 / $115.17 / $115.17
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.95 / $115.17 / $167.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.24 / $117.93 / $135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.61 / $74.84 / $114.07