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Nebraska 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
$18.13 / $18.13 / $44.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.68 / $44.68 / $92.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $67.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.57 / $67.73 / $68.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.61 / $77.06 / $77.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.61 / $77.06 / $118.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.10 / $75.95 / $286.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.01 / $34.95 / $57.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.84 / $77.06 / $97.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.47 / $90.03 / $157.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.30 / $32.29 / $41.84