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North Carolina rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.51 / $70.56 / $166.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.45 / $21.45 / $422.00
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 / $5.25 / $34.92
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $40.00 / $40.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $1,274.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $112.62