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North Carolina 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
$101.98 / $101.98 / $175.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.37 / $101.98 / $101.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.10 / $172.76 / $212.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.08 / $87.35 / $93.17
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 / $64.66 / $102.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.32 / $101.98 / $132.57
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $79.18
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.69 / $135.69 / $208.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.72 / $57.59 / $82.04
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $539.41 / $539.41
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.01 / $583.01 / $848.33