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Arizona 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
Professional
Modifier
Low / Median / High Price
$859.89 / $955.79 / $1,690.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$564.38 / $2,038.84 / $3,686.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,410.95 / $1,881.27 / $2,563.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.01 / $1,107.01 / $1,107.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.12 / $1,107.01 / $1,660.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.59 / $1,436.40 / $9,312.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.03 / $883.84 / $1,331.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.83 / $883.84 / $1,331.38