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Indiana 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
$115.80 / $162.62 / $199.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.35 / $125.38 / $199.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.83 / $209.39 / $233.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.14 / $127.31 / $175.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.42 / $257.36 / $350.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.87 / $257.36 / $315.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.59 / $130.59 / $233.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.33 / $130.59 / $240.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.51 / $112.96 / $157.10