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Washington, DC 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
$20.81 / $20.81 / $20.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $20.81 / $20.81
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.71 / $26.71 / $34.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $25.47 / $25.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $33.04 / $100.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $25.37 / $38.11