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Michigan rates for HCPCS L3570

Orthopedic shoe addition, special extension to instep (leather with eyelets)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.64 / $58.64 / $58.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.72 / $58.64 / $58.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.43 / $309.67 / $564.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.56 / $102.69 / $138.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.16 / $66.75 / $67.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.15 / $82.15 / $82.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.65 / $69.65 / $69.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.75 / $69.65 / $118.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.64 / $74.20 / $74.20
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.38 / $74.20 / $107.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.59 / $75.98 / $87.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.84 / $48.23 / $73.50