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Kentucky rates for HCPCS L3904

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,949.84 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,981.07 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,905.46 / $1,949.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $5,248.07 / $6,918.31
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,897.79 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,888.44 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $3,311.31 / $17,782.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,630.27 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,862.09 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,778.28 / $2,511.89