go back

Michigan rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.94 / $138.94 / $673.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.70 / $24.70 / $61.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.63 / $749.28 / $1,352.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.92 / $34.92 / $34.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $34.92 / $34.92
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.43 / $107.43 / $673.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.83 / $107.43 / $158.47