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Tennessee 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
$1,778.28 / $1,949.84 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,819.70 / $3,311.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,479.11 / $1,995.26
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $20,417.38 / $20,417.38
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,302.68 / $26,302.68 / $26,302.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,819.70 / $2,398.83