go back

Montana rates for HCPCS L3253

Foot, molded shoe, Plastazote (or similar), custom fitted, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.02 / $14.02 / $14.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.32 / $48.26 / $54.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.32 / $54.94 / $58.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.04 / $47.32 / $54.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.55 / $48.53 / $58.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.80 / $19.48 / $29.25