go back

Wisconsin rates for HCPCS L3100

Hallux-valgus night dynamic splint, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.29 / $26.29 / $26.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.86 / $27.94 / $41.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.12 / $57.33 / $94.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.07 / $48.47 / $64.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.50 / $111.54 / $111.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $115.20 / $216.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $75.47 / $98.65
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $39.44 / $59.94
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.84 / $50.84 / $62.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.94 / $52.12 / $242.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.74 / $27.30 / $56.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.82 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $39.44 / $59.94
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.84 / $50.84 / $62.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.12 / $80.22 / $139.51
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $101.80 / $242.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $34.89 / $262.20
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.12 / $52.12 / $52.12
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.62 / $52.12 / $52.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.18 / $26.00 / $52.12