go back

Arizona rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $21.88 / $37.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $28.18 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $25.70 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $42.66 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $30.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $28.18 / $194.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $17.78 / $234.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $20.89 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $17.78 / $26.92