go back

Montana 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
Professional
Modifier
Low / Median / High Price
$80.76 / $591.32 / $591.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.26 / $207.26 / $207.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.11 / $222.84 / $222.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.11 / $222.84 / $222.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.56 / $212.23 / $222.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.11 / $167.26 / $223.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.56 / $93.57 / $143.18