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Texas rates for HCPCS L3904

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

Facilitymedian $2,570 · 10th–90th $1,445–$10,7150%10%10th90th$2,570Professionalmedian $1,585 · 10th–90th $1,413–$2,4550%20%40%10th90th$1,585$5.0$20.0$100.0$500.0$2.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,621.81 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,995.26
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,302.68 / $26,302.68 / $26,302.68
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,630.27 / $4,897.79
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,621.81 / $3,162.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,737.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,454.71 / $4,786.30
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,290.87 / $3,715.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,949.84 / $2,290.87
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,311.31 / $3,311.31