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Idaho 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
$44.57 / $99.04 / $99.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $70.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $68.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.32 / $79.66 / $113.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.80 / $107.45 / $113.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $83.47 / $99.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.04 / $110.46 / $165.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.18 / $81.95 / $118.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.73 / $51.62 / $79.55