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Missouri 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
$289.43 / $428.12 / $441.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.43 / $354.01 / $560.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.45 / $424.45 / $475.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.51 / $665.19 / $2,924.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.51 / $379.58 / $512.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $459.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $335.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.43 / $510.55 / $3,120.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.12 / $342.39 / $646.86
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.89 / $743.89 / $743.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.89 / $318.45 / $466.21