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Nebraska 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
$1,138.03 / $1,138.03 / $1,138.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.03 / $1,138.03 / $1,477.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.44 / $1,725.28 / $1,742.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.35 / $1,962.99 / $1,962.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.35 / $1,962.99 / $3,026.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$894.05 / $1,934.65 / $7,437.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.52 / $890.28 / $1,483.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,957.26 / $1,962.99 / $2,473.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,607.69 / $2,293.04 / $4,044.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.52 / $838.02 / $1,096.64