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Nonstandard Size or Width

Ohio rates for HCPCS L3254

Nonstandard size or width

Rates data updated July 2026.

Facilitymedian $18 · 10th–90th $11$260%20%10th90th$18Professionalmedian $35 · 10th–90th $14$660%10%10th90th$35$2.0$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$17.78
Typical High
$25.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$17.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$45.71
Typical High
$66.07
CareSource
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$239.88
CareSource
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$11.75
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$11.22
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$50.12
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$2.09
Median
$51.29
Typical High
$52.48