go back

Wyoming 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
Professional
Modifier
Low / Median / High Price
$125.70 / $125.70 / $228.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $75.00
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.59 / $142.69 / $191.85