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Maryland 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
$725.32 / $774.07 / $1,385.36
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.00 / $950.00 / $1,211.45
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 / $808.12 / $1,519.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.53 / $1,772.18 / $2,551.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.28 / $884.12 / $1,409.28
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.38 / $1,061.38 / $1,240.53