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Arkansas rates for HCPCS L3925

Finger orthosis (FO), proximal interphalangeal (PIP)/distal interphalangeal (DIP), nontorsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $32.36 / $32.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $32.36 / $50.12
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $54.95 / $75.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $51.29 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $26.92 / $36.31
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $63.10 / $74.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $26.92 / $36.31