go back

Utah 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
$14.15 / $20.92 / $113.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $20.58 / $107.95
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 / $24.80 / $26.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.21 / $28.41 / $36.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.96 / $37.86 / $37.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.57 / $27.15 / $40.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.43 / $17.09 / $17.09