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Wyoming 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
$776.25 / $1,148.15 / $1,698.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $870.96 / $1,819.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $891.25 / $1,318.26