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New Hampshire 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
$19.37 / $19.37 / $23.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.16 / $15.03 / $19.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.40 / $34.40 / $40.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.17 / $19.17 / $20.09
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 / $17.21 / $23.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.85 / $27.85 / $85.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.68 / $16.35 / $18.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.44 / $17.16 / $20.37
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.76 / $28.34 / $36.06