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Minnesota rates for HCPCS L3919

Hand orthosis (HO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $169.82 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $295.12 / $436.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $295.12 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,122.02 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $389.05 / $436.52
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,096.48 / $2,089.30
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $467.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $295.12 / $602.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $131.83 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $131.83 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $147.91 / $363.08