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Louisiana rates for HCPCS L3250

Orthopedic Footwear Custom Molded Shoe Removable Inner Mold Prosthetic Shoe Each (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.88 / $155.41 / $194.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.57 / $144.25 / $156.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.75 / $159.81 / $173.71
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 / $210.68 / $210.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.13 / $132.41 / $224.31