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Oklahoma 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
$837.70 / $837.70 / $1,234.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$806.67 / $837.70 / $1,029.31
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 / $1,312.00 / $1,660.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.59 / $1,098.30 / $9,312.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $883.84 / $1,752.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.23 / $846.95 / $1,267.98