go back

Rhode Island 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
$117.49 / $151.36 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $199.53 / $257.04