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North Carolina 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
$50.99 / $87.98 / $362.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.66 / $50.99 / $65.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.06 / $86.38 / $106.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.54 / $43.67 / $46.58
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 / $83.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.53 / $50.99 / $70.03
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.77 / $43.77 / $43.77
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.20 / $65.20 / $100.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.17 / $29.05 / $45.59
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.36 / $334.02 / $334.02
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.63 / $408.15 / $408.15