go back

Idaho rates for HCPCS L3265

Plastazote Sandal, Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.23 / $12.14 / $13.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.65 / $28.65 / $28.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.91 / $20.91 / $28.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.58 / $8.27 / $14.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.67 / $30.00 / $55.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.98 / $26.64 / $31.17
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.56 / $14.56 / $14.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.17 / $8.66 / $14.32