go back

New Hampshire 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
$157.10 / $157.10 / $230.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.14 / $153.37 / $184.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.00 / $200.72 / $275.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.62 / $267.62 / $317.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.29 / $157.10 / $157.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.00 / $142.00 / $146.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.66 / $103.66 / $146.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.67 / $216.67 / $668.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.86 / $133.51 / $216.67
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $3,000.00 / $3,750.00