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Massachusetts rates for HCPCS L3257

Orthopedic Footwear Additional Charge For Split Size (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.87 / $14.87 / $14.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.23 / $14.87 / $20.57
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.76 / $119.23 / $141.93
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.95 / $25.94 / $40.40
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 / $24.75 / $29.94
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $55.59
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.76 / $119.23 / $119.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.17 / $16.76 / $34.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.17 / $17.42 / $30.01