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Maryland 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
$46.29 / $51.50 / $88.41
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.12 / $63.12 / $77.31
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 / $47.20 / $86.85
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.18 / $113.11 / $162.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.75 / $56.42 / $89.94
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.99 / $61.99 / $79.18