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Idaho rates for HCPCS L3925

Finger Orthosis Proximal Interphalangeal (Pip)/Distal Interphalangeal (Dip) Non Torsion Joint/Spring Extension/Flexion May Include Soft Interface Material Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.40 / $46.40 / $46.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.71 / $46.17 / $65.11
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 / $36.61 / $39.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.53 / $53.99 / $68.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.57 / $64.98 / $68.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $51.11 / $61.57
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $66.81 / $100.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.89 / $47.89 / $71.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.10 / $27.15 / $43.06