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Pennsylvania rates for HCPCS L3901

Wrist-hand-finger orthosis (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated

Facilitymedian $1,995 · 10th–90th $724–$2,8180%20%10th90th$1,995Professionalmedian $912 · 10th–90th $724–$1,6980%20%40%10th90th$912$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,659.59
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,445.44 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,096.48
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,801.89
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,258.93 / $1,819.70
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,621.81
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $2,691.53 / $3,890.45
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,698.24
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,398.83 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $891.25 / $1,819.70