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Montana 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
$135.46 / $991.87 / $991.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.70 / $347.70 / $347.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.98 / $373.84 / $373.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.98 / $373.84 / $373.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.42 / $356.04 / $373.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.98 / $280.58 / $374.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.87 / $156.97 / $240.21