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Minnesota 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
$80.45 / $80.45 / $122.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.48 / $72.38 / $85.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.80 / $123.60 / $162.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.63 / $110.00 / $115.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $356.92 / $991.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.25 / $142.31 / $170.50
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.90 / $342.45 / $780.56
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.25 / $134.25 / $138.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.32 / $115.79 / $539.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $57.31 / $126.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $57.31 / $120.51