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Wrist-Hand-Finger Orthosis (WHFO), Electric Powered

South Dakota rates for HCPCS L3904

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

Rates data updated July 2026.

Facilitymedian $3,467 · 10th–90th $2,188$5,8880%10%10th90th$3,467Professionalmedian $2,951 · 10th–90th $2,042$5,3700%10%20%10th90th$2,951$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,570.40
Typical High
$2,951.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$5,370.32
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$4,073.80
Typical High
$8,128.31
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$2,570.40
Typical High
$25,703.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$3,548.13
Typical High
$3,548.13
Midlands
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$3,630.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$7,762.47
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3,630.78
Median
$4,265.80
Typical High
$5,754.40
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$1,862.09
Typical High
$2,691.53
United
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$2,691.53
Typical High
$4,365.16
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28