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
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $147.91 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $147.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $204.17 / $257.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $245.47 / $416.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $199.53 / $288.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $275.42 / $281.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $281.84 / $331.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $120.23 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $123.03 / $173.78