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Idaho 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
Professional
Modifier
Low / Median / High Price
$224.17 / $428.74 / $498.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $356.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $237.52 / $346.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.71 / $407.74 / $568.90
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.01 / $540.46 / $568.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $419.84 / $500.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.15 / $555.57 / $833.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.23 / $412.50 / $597.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.19 / $259.77 / $400.31