go back

Idaho rates for HCPCS L3250

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.55 / $193.55 / $193.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.62 / $200.00 / $222.39
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 / $210.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.34 / $136.44 / $232.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.04 / $438.72 / $513.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.59 / $142.69 / $235.95