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Connecticut 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
$54.97 / $54.97 / $54.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.21 / $54.03 / $55.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.66 / $113.11 / $129.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.92 / $62.92 / $66.03
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 / $92.03
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.52 / $73.52 / $73.52
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.52 / $73.52 / $104.06
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.59 / $65.59 / $65.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.06 / $56.42 / $94.04