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Connecticut rates for HCPCS L3995

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.36 / $23.36 / $23.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.91 / $21.66 / $23.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.25 / $48.06 / $54.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.33 / $22.33 / $23.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.97 / $29.97 / $29.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.24 / $31.24 / $31.24
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.24 / $31.24 / $44.22
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.97 / $23.97 / $23.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $23.98 / $38.90