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Georgia 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
$55.31 / $55.31 / $131.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.03 / $67.84 / $105.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.46 / $163.04 / $427.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.99 / $96.84 / $185.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.14 / $98.99 / $215.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.99 / $98.99 / $98.99
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 / $68.93 / $102.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.51 / $116.46 / $161.83
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.98 / $201.94 / $219.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.74 / $58.10 / $95.85