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Arizona rates for HCPCS L3809

Wrist-hand-finger orthosis (WHFO), without joint(s), prefabricated, off-the-shelf, any type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.04 / $153.37 / $581.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.72 / $200.72 / $267.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.26 / $253.83 / $458.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.65 / $234.20 / $301.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.00 / $142.00 / $142.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.66 / $103.66 / $318.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.76 / $179.40 / $1,281.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.03 / $122.20 / $191.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.03 / $122.20 / $191.71