go back

Idaho rates for HCPCS L3257

Orthopedic footwear, additional charge for split size

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.09 / $19.09 / $19.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.11 / $19.73 / $21.94
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.81 / $13.46 / $23.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.46 / $43.28 / $50.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.66 / $23.66 / $23.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.27 / $14.08 / $22.12