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Kansas 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
$1,621.81 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,023.29 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $2,691.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,513.56 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $1,023.29 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $977.24 / $1,380.38