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Montana rates for HCPCS L3904

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

Facilitymedian $4,169 · 10th–90th $2,570–$5,2480%20%10th90th$4,169Professionalmedian $2,188 · 10th–90th $1,479–$5,2480%10%10th90th$2,188$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,949.84 / $3,162.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,570.88 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,570.88 / $4,570.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,168.69 / $8,128.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,168.69 / $8,128.31
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,801.89 / $5,011.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,235.94 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,995.26 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,621.81 / $2,454.71