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New Hampshire rates for HCPCS L3201

Orthopedic Shoe Oxford With Supinator Or Pronator Infant (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.45 / $27.45 / $32.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.67 / $24.24 / $27.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.47 / $41.47 / $41.47
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.84 / $58.84 / $181.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.94 / $23.92 / $48.45
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.12 / $67.23 / $85.57