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Arizona rates for HCPCS L3257

Orthopedic footwear, additional charge for split size

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $10.40 / $21.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.52 / $84.97 / $153.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.80 / $78.40 / $106.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.09 / $28.09 / $28.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.51 / $20.51 / $28.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.02 / $10.81 / $115.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.66 / $14.08 / $26.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.90 / $14.08 / $26.28