go back

Utah rates for HCPCS L3923

Hand Finger Orthosis Without Joints May Include Soft Interface Straps Prefabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.89 / $30.89 / $30.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.89 / $59.92 / $276.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.92 / $59.92 / $59.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.74 / $66.48 / $79.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.56 / $70.01 / $91.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.97 / $93.65 / $93.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.33 / $67.13 / $100.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.26 / $47.41 / $57.54