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Utah 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
$15.67 / $15.67 / $15.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.15 / $15.67 / $25.79
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $45.00 / $74.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.65 / $42.84 / $54.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.76 / $32.76 / $32.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $19.48 / $23.89