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Indiana rates for HCPCS L3900

Wrist-hand-finger orthosis (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$879.18 / $879.18 / $1,776.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.25 / $879.18 / $954.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,403.29 / $1,589.81 / $1,776.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.33 / $859.43 / $1,186.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,332.24 / $1,953.95 / $2,583.38
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,509.87 / $1,953.95 / $2,398.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.35 / $891.35 / $1,776.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$650.69 / $891.35 / $1,555.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.44 / $843.29 / $1,152.82