go back

South Carolina 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
$16.96 / $16.96 / $16.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.96 / $16.96 / $34.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.00 / $26.78 / $36.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $30.06 / $32.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.94 / $30.06 / $30.06
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.96 / $21.03 / $52.76
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.00 / $44.40 / $44.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $20.90 / $34.01