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Alaska rates for HCPCS L3921

Hand-finger orthosis (HFO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $204.17 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $229.09
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $295.12 / $331.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $346.74 / $1,122.02
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $338.84 / $346.74
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $338.84 / $346.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $102.33 / $346.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $213.80 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $269.15 / $851.14