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Michigan rates for HCPCS L3540

Orthopedic shoe addition, sole, full

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $35.00 / $35.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.09 / $35.00 / $35.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.29 / $61.29 / $61.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.77 / $184.83 / $336.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.23 / $61.29 / $82.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $39.84 / $40.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $49.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $36.72 / $36.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.72 / $36.72 / $70.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $44.28 / $44.28
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $44.28 / $64.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $45.35 / $52.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.39 / $28.78 / $41.82