go back

Oklahoma 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
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $61.66 / $104.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $125.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $74.13 / $363.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $56.23 / $141.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $117.49 / $120.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $51.29 / $74.13