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Pennsylvania rates for HCPCS L3649

Orthopedic Shoe Modification Addition Or Transfer Not Otherwise Specified (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.00 / $15.14 / $34.64
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
$64,999.35 / $64,999.35 / $64,999.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.00 / $15.14 / $69.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12