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Arizona rates for HCPCS L3250

Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.13 / $105.44 / $212.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.64 / $312.99 / $565.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.60 / $288.80 / $393.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.68 / $210.68 / $210.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.80 / $153.80 / $401.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.44 / $109.34 / $1,166.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.33 / $142.69 / $265.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.81 / $142.69 / $265.85