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Arkansas rates for HCPCS L3915

Wrist Hand Orthosis Includes One Or More Non- Torsion Joint(S) Elastic Bands Turnblocks May Include Soft Interface Straps Prefabricated Itemthat Has Been Trimmed Bent Molded Assembled Orotherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.70 / $325.70 / $325.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.81 / $325.70 / $325.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.80 / $468.80 / $468.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.89 / $669.56 / $743.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.90 / $568.90 / $586.05
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.90 / $568.90 / $568.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $468.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $325.37 / $457.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.18 / $272.45 / $352.30