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Delaware 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
$22.80 / $57.61 / $119.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.80 / $26.69 / $43.46
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 / $36.61
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $130.00 / $130.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.49 / $27.64 / $41.63