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Montana 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
$688.17 / $5,039.00 / $5,039.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.05 / $1,393.05 / $1,393.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.35 / $1,497.80 / $1,497.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.35 / $1,218.02 / $1,497.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$795.30 / $1,426.48 / $1,497.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.35 / $1,124.17 / $1,561.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.21 / $711.65 / $814.65