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California rates for HCPCS L3003

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.64 / $112.64 / $591.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.54 / $112.64 / $591.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.54 / $310.89 / $650.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.41 / $111.51 / $195.22
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $242.61 / $433.23
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $271.93 / $633.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.11 / $149.11 / $162.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.85 / $108.85 / $153.58
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.95 / $204.94 / $245.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.96 / $143.46 / $317.66
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.65 / $977.65 / $977.65
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.91 / $1,056.91 / $1,537.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.67 / $432.67 / $432.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.40 / $181.17 / $211.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.85 / $149.11 / $195.07
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.83 / $386.83 / $386.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.96 / $93.57 / $204.94