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Maine 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
$164.32 / $208.66 / $208.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.76 / $396.14 / $734.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.64 / $200.79 / $200.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.98 / $212.98 / $212.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.47 / $212.98 / $296.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.33 / $278.33 / $278.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.58 / $208.66 / $208.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.94 / $171.50 / $394.41