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Nebraska 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
$19.57 / $19.57 / $19.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $19.57 / $37.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.50 / $23.50 / $65.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.48 / $77.58 / $77.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.63 / $67.63 / $77.58