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Virginia 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
$18.75 / $22.60 / $22.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.75 / $22.60 / $22.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.47 / $41.47 / $50.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.28 / $39.28 / $39.28
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.65 / $37.11 / $49.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.55 / $25.99 / $47.59
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.05 / $44.40 / $83.33
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.05 / $37.47 / $60.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.05 / $37.47 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.35 / $26.25 / $45.76