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Oklahoma 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
$21.88 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $20.89 / $30.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
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 / $39.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $30.20 / $144.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $22.39 / $57.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $38.02 / $41.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $17.78 / $25.70