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Texas 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
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $23.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $90.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.97 / $65.97 / $65.97
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $19.57 / $33.63
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.50 / $23.50 / $23.50
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.16 / $23.24 / $25.97
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $19.57 / $27.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $23.72
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.00 / $189.00 / $189.00