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Wisconsin rates for HCPCS L3904

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

Facilitymedian $3,802 · 10th–90th $3,020–$6,9180%20%40%10th90th$3,802Professionalmedian $2,399 · 10th–90th $1,514–$5,6230%20%10th90th$2,399$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
$1,862.09 / $1,862.09 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,548.13 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $8,709.64 / $18,620.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $5,370.32 / $7,079.46
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,019.95 / $4,677.35
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,715.35 / $17,378.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,905.46 / $4,168.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,995.26
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $6,025.60
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $4,265.80 / $7,413.10
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $5,623.41 / $10,232.93
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $7,585.78 / $20,417.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,951.21 / $26,302.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,905.46 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,862.09 / $3,162.28