go back

South Carolina rates for HCPCS L3201

Orthopedic shoe, Oxford with supinator or pronator, infant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $20.89 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $27.54 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $30.20 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $30.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $25.70 / $63.10
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $17.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $26.92 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $21.88 / $34.67