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Connecticut 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
$24.71 / $24.71 / $24.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $24.71 / $27.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.40 / $50.84 / $58.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.25 / $27.25 / $29.70
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 / $34.89
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.04 / $33.04 / $33.04
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $33.04 / $46.77
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.26 / $24.26 / $24.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.46 / $25.37 / $47.42