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Wisconsin rates for HCPCS L3410

Metatarsal Bar Wedge Between Sole (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.42 / $56.42 / $56.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.42 / $56.42 / $101.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.85 / $123.04 / $203.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.66 / $104.02 / $137.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.45 / $239.36 / $239.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $247.45 / $467.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $162.19 / $211.69
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.18 / $84.63 / $128.63
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.04 / $109.17 / $134.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.71 / $111.85 / $520.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.85 / $58.59 / $121.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.38 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.18 / $84.63 / $128.63
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.04 / $109.17 / $134.22
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.85 / $172.13 / $299.10
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $218.46 / $520.92
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $66.72 / $563.39
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.85 / $111.85 / $111.85
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.30 / $111.85 / $111.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.28 / $55.80 / $99.17