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Illinois rates for HCPCS L3390

Outflare Wedge (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.72 / $30.72 / $59.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $30.72 / $47.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $121.05 / $514.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.52 / $45.42 / $45.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.99 / $43.99 / $65.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $43.99 / $69.38
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.47 / $68.09 / $83.66
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.69 / $77.69 / $77.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.53 / $45.05 / $47.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.19 / $29.81 / $52.80