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Mississippi rates for HCPCS L3917

Hand Orthosis Metacarpal Fracture Orthosis Pre- Fabricated Item That Has Been Trimmed Bent Moldemolded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.27 / $65.27 / $104.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $74.45 / $104.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.25 / $90.25 / $90.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.25 / $90.25 / $90.25
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 / $64.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $55.29 / $86.74