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Ohio 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
$24.91 / $24.91 / $41.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.57 / $24.91 / $24.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.14 / $37.95 / $102.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.25 / $52,499.48 / $61,249.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.36 / $37.36 / $51.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $23.72
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $23.72 / $23.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $50.90 / $50.90