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Wyoming rates for HCPCS L3904

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,178.67 / $2,410.53 / $3,769.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,203.63 / $4,203.63 / $4,203.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,203.63 / $4,203.63 / $4,203.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,017.28 / $2,017.28 / $3,551.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,472.61 / $1,472.61 / $2,017.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,455.70 / $1,610.60 / $1,788.09