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West 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
$73.31 / $73.31 / $73.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.68 / $27.96 / $34.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.85 / $79.23 / $99.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.01 / $40.76 / $69.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.61 / $36.61 / $70.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.73 / $36.61 / $295.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.69 / $58.69 / $58.69
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.21 / $35.21 / $35.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.53 / $27.64 / $43.62