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Utah rates for HCPCS L3540

Orthopedic Shoe Addition Sole Full (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.64 / $17.64 / $17.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.64 / $20.44 / $172.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $36.72 / $36.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.81 / $36.72 / $39.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $45.24 / $59.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.27 / $60.52 / $60.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $43.38 / $65.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.39 / $27.08 / $34.99