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Pennsylvania 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
$141.47 / $141.47 / $547.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.53 / $156.53 / $216.73
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.77 / $343.78 / $343.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.98 / $212.98 / $343.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.47 / $155.47 / $301.02
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.27 / $343.78 / $653.17
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.00 / $354.00 / $354.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.47 / $141.47 / $547.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.53 / $165.56 / $525.36
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.00 / $161.69 / $556.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.98 / $212.98 / $343.78
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.47 / $155.47 / $408.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.79 / $327.20 / $327.20
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.79 / $327.20 / $335.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.57 / $173.22 / $310.02