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Montana rates for HCPCS L3420

Full Sole And Heel Wedge Between Sole (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.35 / $185.61 / $185.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.78 / $69.93 / $69.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.78 / $69.93 / $69.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.82 / $66.59 / $69.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.49 / $53.66 / $69.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.54 / $29.36 / $33.61