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Alaska rates for HCPCS L3905

Wrist-hand orthosis (WHO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $630.96 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $645.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $912.01 / $1,023.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $3,467.37
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,047.13 / $1,071.52
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,047.13 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $602.56 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $478.63 / $630.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $831.76 / $2,630.27