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Vermont 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
$24.81 / $24.81 / $30.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $34.89 / $34.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.73 / $25.47 / $37.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $34.89 / $34.89
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.73 / $34.89 / $37.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $30.12 / $58.78