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Vermont 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
$14.16 / $14.16 / $17.05
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 / $28.09 / $33.15
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.09 / $28.09 / $28.09
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.51 / $28.09 / $33.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.46 / $21.87 / $36.53