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Maine 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
Professional
Modifier
Low / Median / High Price
$599.60 / $832.97 / $832.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,220.53 / $1,581.31 / $2,931.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.52 / $801.53 / $801.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $907.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $907.46 / $1,117.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,111.10 / $1,111.10 / $1,111.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.70 / $832.97 / $832.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.81 / $772.49 / $1,574.44