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North Carolina 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
$1,690.94 / $1,690.94 / $2,916.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.46 / $1,690.94 / $1,690.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.26 / $1,857.92 / $3,527.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,344.43 / $1,448.33 / $1,544.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.01 / $1,107.01 / $1,194.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.12 / $1,194.53 / $1,800.06
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.59 / $1,690.94 / $2,198.21
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,086.00 / $1,086.00 / $1,313.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,885.84 / $2,085.59 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.53 / $963.41 / $1,360.28
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,049.64 / $10,211.21 / $10,211.21
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,304.00 / $11,304.00 / $14,700.08