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Vermont 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
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $32.36 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $27.54 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $36.31
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $53.70 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $26.92 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $41.69 / $120.23