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Minnesota 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
$28.53 / $50.05 / $50.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $39.59 / $65.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.08 / $76.88 / $101.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.62 / $68.43 / $72.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.61 / $222.43 / $617.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.63 / $88.64 / $106.20
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.05 / $213.41 / $486.44
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.63 / $83.63 / $86.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.05 / $72.03 / $286.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.10 / $29.95 / $76.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.10 / $29.95 / $72.33