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Alabama rates for HCPCS L3917

Hand Orthosis Metacarpal Fracture Orthosis Pre- Fabricated Item That Has Been Trimmed Bent Moldemolded Assembled Or Otherwise 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
$105.04 / $105.04 / $105.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.72 / $105.04 / $105.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.68 / $86.68 / $86.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $115.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $101.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $51.62 / $79.98