go back

Maine 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
$27.49 / $34.92 / $34.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.17 / $66.29 / $122.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.60 / $34.72 / $34.72
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.59 / $46.59 / $46.59
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.39 / $34.92 / $34.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.14 / $29.29 / $66.00