go back

Utah rates for HCPCS L3520

Orthopedic shoe addition, insole, felt covered with leather

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $19.95 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $21.38 / $21.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $44.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $28.18 / $37.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $33.88 / $58.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $27.54 / $39.81
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $38.90 / $39.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $39.81 / $45.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $16.98 / $19.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $16.98 / $24.55