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Vermont 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
$277.62 / $277.62 / $320.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.63 / $142.63 / $154.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.27 / $460.27 / $460.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $325.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $438.88 / $467.69
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $325.37
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $439.26 / $467.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.21 / $337.00 / $657.67