go back

Pennsylvania rates for HCPCS L3254

Nonstandard size or width

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.05 / $54.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.00 / $14.05 / $17.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.75 / $10.75 / $10.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $10.75
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.05 / $54.37
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.05 / $14.05 / $18.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.20 / $23.20 / $23.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.75 / $10.75 / $10.75
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $10.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $50.90 / $50.90