go back

Maryland rates for HCPCS L3257

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.30 / $11.50 / $19.67
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.39 / $25.06 / $34.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.51 / $17.18 / $26.21
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.92 / $54.93 / $54.93