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New Hampshire rates for HCPCS L3221

Orthopedic Footwear Mens Shoe Depth Inlay Each Covered By Medicare. Statute Reference: 1862a8)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.44 / $67.44 / $80.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.80 / $59.46 / $67.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.15 / $82.15 / $82.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.84 / $69.84 / $69.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.99 / $50.99 / $69.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.49 / $188.49 / $581.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.11 / $58.66 / $126.20