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Minnesota rates for HCPCS L3255

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $19.57 / $19.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.14 / $19.57 / $24.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.69 / $15.69 / $92.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.55 / $15.69 / $15.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.93 / $23.72 / $23.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $19.57 / $33.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $50.90 / $50.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $50.90 / $50.90