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Maine rates for HCPCS L3809

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.58 / $62.58 / $139.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.93 / $159.56 / $162.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.02 / $308.38 / $571.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.29 / $155.29 / $157.10
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 / $142.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.67 / $216.67 / $216.67
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.58 / $62.58 / $139.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.93 / $162.43 / $179.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.68 / $134.19 / $307.04