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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$22.21 / $27.95 / $30.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.89 / $97.08 / $114.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.34 / $28.63 / $45.98
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.86 / $25.37 / $42.28