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New Hampshire 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
$17.05 / $17.05 / $20.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.45 / $14.87 / $17.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.93 / $54.93 / $54.93
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 / $29.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $163.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $14.66 / $30.01