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Minnesota 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
$16.38 / $16.38 / $16.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.23 / $16.38 / $20.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.65 / $63.65 / $367.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.92 / $63.65 / $63.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.09 / $68.28 / $189.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $27.23 / $31.43
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.54 / $64.88 / $149.33
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $24.75 / $26.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.81 / $31.36 / $115.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.38 / $14.24 / $31.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.38 / $15.38 / $31.64