go back

Utah rates for HCPCS L3807

Wrist-hand-finger orthosis (WHFO), without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.29 / $32.29 / $78.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.00 / $130.00 / $616.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.00 / $135.00 / $135.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.55 / $135.00 / $225.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.44 / $202.33 / $263.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.69 / $270.66 / $270.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.12 / $194.01 / $291.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.88 / $122.20 / $150.63