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Pennsylvania rates for HCPCS L3540

Orthopedic shoe addition, sole, full

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.63 / $24.63 / $95.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.43 / $27.25 / $34.70
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.57 / $59.84 / $59.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $36.72 / $59.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.81 / $26.81 / $52.40
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.05 / $59.84 / $113.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.63 / $24.63 / $95.32
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.43 / $28.30 / $47.87
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.40 / $85.40 / $117.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $36.72 / $59.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.81 / $26.81 / $70.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.80 / $56.96 / $56.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.80 / $56.96 / $58.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.62 / $29.98 / $52.29