go back

Idaho rates for HCPCS L3201

Orthopedic shoe, Oxford with supinator or pronator, infant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.13 / $31.13 / $31.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.51 / $32.17 / $35.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.06 / $30.06 / $30.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.94 / $21.94 / $30.06
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.55 / $21.95 / $37.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.92 / $70.56 / $82.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $38.58 / $38.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.65 / $22.95 / $54.43