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Maine rates for HCPCS L3253

Foot Molded Shoe Plastazote (Or Similar) Custom Fitted Each (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.58 / $23.76 / $23.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.64 / $67.64 / $67.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.94 / $54.94 / $54.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $54.94 / $54.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.24 / $88.24 / $88.24
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.46 / $23.76 / $23.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.02 / $21.44 / $51.77