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Mississippi 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
$122.89 / $122.89 / $195.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.89 / $144.25 / $208.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$961.80 / $961.80 / $1,057.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.00 / $916.00 / $916.00
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $42.50 / $190.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.13 / $125.53 / $213.91