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Maine rates for HCPCS L3927

Finger orthosis (FO), proximal interphalangeal (PIP)/distal interphalangeal (DIP), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.02 / $57.02 / $57.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.89 / $22.69 / $22.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.26 / $43.10 / $79.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.75 / $21.86 / $21.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.80 / $24.80 / $24.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.10 / $18.10 / $24.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.28 / $30.28 / $30.28
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.02 / $57.02 / $57.02
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.57 / $22.69 / $23.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.38 / $19.25 / $51.77