go back

New Mexico 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
$48.12 / $48.12 / $48.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.79 / $69.33 / $92.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.31 / $117.75 / $133.90
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 / $69.84 / $104.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $141.94 / $212.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.24 / $43.24 / $126.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.99 / $69.84 / $69.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.08 / $56.30 / $105.12