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South Carolina rates for HCPCS L3901

Wrist Hand Finger Orthosis 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
$955.78 / $955.79 / $2,018.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.80 / $955.79 / $1,690.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,120.00 / $1,378.38 / $2,046.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$860.06 / $1,107.01 / $1,222.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.12 / $1,473.58 / $1,619.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$859.33 / $1,384.00 / $3,032.78
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,086.00 / $1,086.00 / $1,167.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.91 / $1,304.91 / $1,304.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.27 / $920.45 / $1,191.50