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Oklahoma 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
$24.75 / $24.75 / $36.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.84 / $24.75 / $27.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.19 / $45.84 / $45.84
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 / $34.89 / $34.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $31.45 / $242.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.48 / $24.95 / $51.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.48 / $23.21 / $33.31