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Washington rates for HCPCS L3904

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

Facilitymedian $3,311 · 10th–90th $2,188–$7,9430%20%10th90th$3,311Professionalmedian $2,399 · 10th–90th $1,479–$5,1290%10%20%10th90th$2,399$1.0$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
$2,187.76 / $2,187.76 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,949.84 / $3,467.37
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,162.28 / $3,162.28
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,995.26
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $4,570.88 / $9,332.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $4,073.80 / $7,413.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $2,238.72 / $2,691.53
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,162.28 / $3,388.44
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,388.44 / $7,585.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $4,677.35 / $6,456.54
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $3,162.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $4,365.16 / $5,248.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,819.70 / $3,090.30
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,290.87 / $4,897.79