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Arizona 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
Professional
Modifier
Low / Median / High Price
$45.24 / $61.26 / $101.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.70 / $107.28 / $193.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.23 / $98.98 / $134.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $64.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $94.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.32 / $75.54 / $539.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.61 / $51.62 / $77.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.66 / $51.62 / $77.76