go back

Iowa rates for HCPCS L3257

Orthopedic footwear, additional charge for split size

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.38 / $16.38 / $20.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.92 / $13.23 / $21.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.09 / $28.09 / $28.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $28.09 / $31.55
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.23 / $87.66 / $93.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.23 / $43.56 / $115.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $16.59 / $49.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.48 / $31.55 / $49.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.35 / $39.90 / $54.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $13.27 / $33.57
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.73 / $184.73 / $184.73
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.94 / $184.73 / $184.73