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North Dakota 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
$25.70 / $25.70 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $21.88 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $39.81 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $52.48 / $64.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $34.67 / $194.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $17.78 / $36.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $58.88 / $58.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $19.95 / $47.86