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Nebraska 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
$33.06 / $33.06 / $33.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.06 / $33.06 / $42.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.57 / $50.11 / $50.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $57.04 / $57.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.89 / $57.04 / $87.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.98 / $56.20 / $242.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.89 / $25.87 / $43.11
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.87 / $57.04 / $71.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.00 / $67.41 / $117.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.89 / $25.87 / $35.02