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New Hampshire 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
$163.22 / $195.86 / $451.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.30 / $126.65 / $175.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.86 / $289.86 / $343.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.36 / $155.36 / $169.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.58 / $176.58 / $176.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.90 / $176.58 / $236.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.69 / $234.69 / $724.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.41 / $144.61 / $171.72
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.10 / $254.92 / $382.96