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Colorado 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
Facility
Modifier
Low / Median / High Price
$29.48 / $29.48 / $29.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $29.48 / $39.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.65 / $59.16 / $107.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.25 / $27.25 / $29.43
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 / $55.48
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $25.94 / $66.23
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.99 / $14.99 / $14.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.43 / $65.81 / $104.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.08 / $23.21 / $34.97