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Pennsylvania 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
$298.74 / $298.74 / $1,156.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.32 / $316.31 / $428.12
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.71 / $501.71 / $568.61
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
$509.38 / $668.95 / $668.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $606.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $802.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.91 / $606.42 / $1,152.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,020.66 / $3,020.66 / $3,020.66
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.72 / $522.62 / $535.16
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.74 / $298.74 / $1,156.11
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.31 / $328.02 / $485.14
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.00 / $285.20 / $1,194.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $606.42
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $802.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.68 / $319.68 / $636.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.68 / $636.72 / $649.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.54 / $401.37 / $603.29