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New Hampshire rates for HCPCS L3050

Foot Arch Support Removable Premolded Metatarsal Each (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.16 / $31.16 / $37.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.77 / $24.18 / $33.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.34 / $55.34 / $65.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.80 / $30.80 / $32.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.65 / $31.65 / $31.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.10 / $23.10 / $31.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.80 / $44.80 / $138.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $26.30 / $29.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.39 / $27.61 / $32.78
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.15 / $39.77 / $50.61