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Maine 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
$54.03 / $68.65 / $68.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.60 / $130.34 / $241.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.92 / $66.03 / $66.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $83.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $92.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.57 / $91.57 / $91.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $68.65 / $68.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.61 / $56.42 / $129.75