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Massachusetts rates for HCPCS L3500

Orthopedic Shoe Addition Insole Leather (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.03 / $15.03 / $15.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.03 / $16.28 / $22.02
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.32 / $97.08 / $164.13
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.26 / $26.10 / $34.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.58 / $23.58 / $23.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.21 / $23.58 / $40.88
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.85 / $27.85 / $29.24
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.60 / $12.60 / $12.60
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $164.13 / $164.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.09 / $17.16 / $33.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $15.57 / $18.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.44 / $18.38 / $33.59