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Arkansas rates for HCPCS L3933

Finger orthosis (FO), without joints, may include soft interface, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.74 / $130.74 / $404.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.37 / $130.74 / $209.35
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.17 / $188.17 / $188.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.05 / $268.75 / $298.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.32 / $228.32 / $235.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.32 / $228.32 / $228.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.59 / $130.59 / $188.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.33 / $130.59 / $183.76
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.40 / $216.40 / $216.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.51 / $105.96 / $141.74