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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$774.07 / $1,050.74 / $1,196.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,504.82 / $3,383.09 / $4,005.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.04 / $931.04 / $1,557.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,024.74 / $1,107.01 / $1,107.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.12 / $1,533.73 / $1,660.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.08 / $883.84 / $1,473.07