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Georgia 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
$24.86 / $24.86 / $59.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.55 / $27.95 / $34.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.36 / $73.30 / $192.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.25 / $43.53 / $83.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.21 / $44.51 / $96.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.51 / $44.51 / $44.51
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 / $32.97 / $60.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.26 / $52.36 / $73.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.41 / $26.12 / $43.10