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Arkansas rates for HCPCS L3901

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$984.71 / $984.71 / $984.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.10 / $984.71 / $984.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,529.41 / $2,024.22 / $2,249.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,772.18 / $1,772.18 / $1,931.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,772.18 / $1,772.18 / $1,772.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.01 / $1,107.01 / $1,417.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.12 / $1,107.01 / $1,384.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $844.44 / $1,183.75