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Kansas 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
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $61.66 / $95.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $91.20 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $134.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $79.43 / $257.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $57.54 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $91.20 / $91.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $54.95 / $77.62