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Maine 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
Professional
Modifier
Low / Median / High Price
$668.76 / $870.56 / $870.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.61 / $1,652.69 / $3,063.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.43 / $910.30 / $910.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.35 / $891.35 / $1,054.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$650.69 / $891.35 / $1,251.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.24 / $1,161.24 / $1,161.24
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.59 / $870.56 / $870.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.02 / $715.53 / $1,645.50