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Ohio 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
$33.34 / $62.19 / $209.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.47 / $62.19 / $71.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.73 / $127.37 / $330.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.49 / $62.92 / $152.84
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.42 / $98.42 / $98.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.84 / $115.79 / $156.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.70 / $104.81 / $247.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $136.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $94.95
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $64.66 / $64.66
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $64.66 / $64.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.51 / $55.36 / $77.78