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Arkansas 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
Facility
Modifier
Low / Median / High Price
$607.62 / $607.62 / $607.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.99 / $607.62 / $607.62
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.39 / $1,061.39 / $1,093.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.39 / $1,061.39 / $1,061.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $607.01 / $874.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.12 / $607.00 / $854.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.08 / $492.44 / $658.72