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Arizona 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
$47.63 / $47.63 / $47.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.13 / $32.67 / $100.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.46 / $66.70 / $120.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.15 / $61.54 / $83.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.61 / $36.61 / $36.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.73 / $26.73 / $83.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.53 / $30.94 / $286.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.51 / $27.15 / $41.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.53 / $27.15 / $40.89