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New Jersey 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
$1,099.05 / $1,099.05 / $1,099.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,099.05 / $1,469.98 / $1,987.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,879.15 / $2,017.28 / $3,228.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,472.61 / $1,472.61 / $2,826.89
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,949.37 / $2,970.12 / $4,229.18
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,152.72 / $3,228.39 / $3,228.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,455.70 / $1,610.60 / $3,228.39