go back

Kentucky 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
$13.11 / $19.38 / $20.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $20.30 / $24.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.04 / $27.04 / $27.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.47 / $37.70 / $39.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.64 / $21.61 / $22.33
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.28 / $53.16 / $71.63
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.70 / $50.90 / $63.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.97 / $29.97 / $48.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $27.63 / $202.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.72 / $24.05 / $30.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.54 / $18.82 / $28.76