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Illinois rates for HCPCS L5000

Partial Foot Shoe Insert With Longitudinal Arch Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.44 / $342.44 / $691.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.74 / $364.22 / $509.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.66 / $494.66 / $494.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$826.80 / $1,398.80 / $5,953.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.82 / $525.82 / $552.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $696.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $810.15
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.09 / $739.21 / $974.11
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.43 / $899.43 / $899.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.02 / $521.47 / $547.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.39 / $345.16 / $592.53