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Minnesota rates for HCPCS L3901

Wrist Hand Finger Orthosis 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
$1,617.53 / $1,617.53 / $1,617.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.06 / $1,617.53 / $1,651.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,006.40 / $2,484.78 / $3,273.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.38 / $2,211.57 / $2,327.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.01 / $7,182.88 / $19,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.88 / $2,860.81 / $3,427.57
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,264.39 / $6,891.62 / $15,708.54
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.88 / $2,698.88 / $2,777.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.71 / $2,327.96 / $9,312.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $986.96 / $2,337.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $986.96 / $3,681.88