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New York 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
$38.49 / $54.47 / $115.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.49 / $49.41 / $71.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.11 / $115.37 / $226.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.92 / $62.92 / $175.26
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.63 / $94.23 / $94.23
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.23 / $94.23 / $94.23
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 / $92.03
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.11 / $254.50 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.78 / $83.70 / $203.60
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.98 / $75.98 / $75.98
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.98 / $72.22 / $91.18
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $134.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.61 / $60.23 / $103.48
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.98 / $67.98 / $75.54
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.98 / $67.98 / $75.98