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Georgia 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
$519.21 / $519.21 / $1,233.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.89 / $583.45 / $868.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,093.33 / $1,530.68 / $4,012.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.12 / $909.08 / $1,745.43
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.18 / $929.34 / $2,022.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$929.34 / $929.34 / $929.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $607.01 / $607.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.12 / $647.10 / $961.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$830.94 / $1,093.33 / $1,518.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.08 / $1,410.41 / $2,063.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.63 / $522.77 / $788.44