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Illinois rates for HCPCS L3904

Wrist-hand-finger orthosis (WHFO), external powered, electric, custom fabricated

Facilitymedian $4,169 · 10th–90th $1,905–$19,0550%20%10th90th$4,169Professionalmedian $1,905 · 10th–90th $1,479–$3,8020%20%40%10th90th$1,905$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$1,905.46 / $1,905.46 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,905.46 / $3,548.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $7,244.36 / $25,703.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,398.83 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $3,715.35
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,073.80 / $5,128.61
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,019.95 / $5,248.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,862.09 / $2,884.03