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Indiana 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
Facility
Modifier
Low / Median / High Price
$174.34 / $174.34 / $430.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.63 / $177.60 / $189.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.27 / $315.25 / $352.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.81 / $191.64 / $258.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.58 / $387.46 / $528.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.39 / $387.46 / $475.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.98 / $212.98 / $352.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.47 / $212.98 / $361.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.64 / $168.38 / $236.50