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Virginia 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
$22.67 / $27.40 / $69.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.67 / $27.40 / $41.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.40 / $55.40 / $58.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.60 / $32.60 / $40.75
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.11 / $29.11 / $37.86
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.78 / $49.86 / $66.48
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.53 / $32.39 / $61.89
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.77 / $66.00 / $92.28
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.96 / $42.01 / $69.37
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.96 / $42.01 / $69.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.98 / $27.64 / $41.63