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South Carolina 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
Facility
Modifier
Low / Median / High Price
$14.40 / $14.40 / $14.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $28.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.50 / $89.00 / $115.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.71 / $54.94 / $86.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $40.11 / $54.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.40 / $17.86 / $44.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.07 / $35.07 / $85.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.99 / $17.98 / $29.24