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Indiana rates for HCPCS L3765

Elbow Wrist Hand Finger Orthosis Rigid Without Joints May Include Soft Interface Straps Custom Fabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.91 / $695.91 / $1,406.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.14 / $698.47 / $755.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.76 / $1,258.40 / $1,406.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.90 / $735.52 / $992.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,060.22 / $1,546.63 / $2,109.05
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.13 / $1,546.63 / $1,898.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $1,406.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $907.46 / $1,442.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.75 / $684.64 / $965.61