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Idaho 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
$107.03 / $208.05 / $382.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.97 / $172.09 / $209.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.59 / $130.59 / $143.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.33 / $95.33 / $139.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.31 / $160.85 / $228.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.49 / $216.90 / $228.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $170.57 / $205.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.93 / $222.97 / $334.46
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.82 / $165.56 / $239.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.41 / $104.27 / $165.37