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Michigan 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
$21.92 / $21.92 / $25.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.61 / $22.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.09 / $115.74 / $210.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.46 / $38.38 / $51.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.32 / $24.95 / $25.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.70 / $30.70 / $30.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.80 / $24.80 / $24.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.80 / $24.80 / $44.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.92 / $27.74 / $27.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.57 / $27.74 / $44.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $18.03 / $27.48