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North Dakota 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
$1,651.45 / $1,651.45 / $1,651.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,560.10 / $1,617.53 / $1,651.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,122.34 / $2,509.35 / $2,571.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,698.88 / $2,725.86 / $3,427.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.18 / $1,651.45 / $9,312.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$769.44 / $981.24 / $1,808.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $981.24 / $1,808.59