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Washington rates for HCPCS L3230

Orthopedic Footwear Custom Shoes Depth Inlay Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.40 / $259.69 / $271.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.66 / $114.40 / $114.40
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.56 / $600.04 / $600.04
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.54 / $378.87 / $986.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.08 / $139.08 / $139.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.53 / $101.53 / $139.08
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $239.24 / $385.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $225.62 / $310.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.35 / $268.17 / $536.34
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.45 / $223.95 / $287.49
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.49 / $287.49 / $287.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.05 / $169.26 / $309.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.76 / $80.77 / $122.34
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.35 / $85.35 / $164.17