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Hawaii 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
Professional
Modifier
Low / Median / High Price
$34.00 / $65.11 / $65.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.08 / $59.08 / $59.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.61 / $36.61 / $81.79
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.34 / $77.84 / $77.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.93 / $74.34 / $104.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.54 / $69.52 / $81.79
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.23 / $61.95 / $70.77