go back

Arkansas rates for HCPCS L3917

Hand orthosis (HO), metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.70 / $64.70 / $64.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.26 / $64.70 / $64.70
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
$100.50 / $133.02 / $147.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.11 / $113.11 / $116.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.11 / $113.11 / $113.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $93.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $90.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $52.44 / $70.15