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Arizona rates for HCPCS L3100

Hallus-Valgus Night Dynamic Splint Prefabricated Off-The-Shelf (Revised 01/01/14) (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.34 / $27.94 / $90.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $48.21 / $87.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.36 / $44.49 / $60.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $34.89 / $34.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $25.47 / $60.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $33.97 / $242.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.96 / $23.21 / $34.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.96 / $23.21 / $34.97