go back

Virginia rates for HCPCS L3254

Non-Standard Size Or Width (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.14 / $14.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.05 / $14.14 / $14.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.38 / $65.38 / $80.39
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.52 / $24.52 / $24.52
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.00 / $29.00 / $29.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.14 / $21.54
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $9,929.00 / $10,945.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $9,929.00 / $10,945.00