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Iowa 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
$755.56 / $755.56 / $799.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.81 / $583.45 / $976.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $607.01 / $1,190.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.01 / $1,260.75 / $1,575.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.00 / $1,082.08 / $1,101.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.18 / $1,284.45 / $5,063.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.53 / $546.98 / $1,478.45
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.82 / $1,190.30 / $1,475.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.86 / $1,390.43 / $2,274.63
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.41 / $1,164.61 / $1,970.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.09 / $539.84 / $1,273.23
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,027.99 / $1,027.99 / $1,027.99
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.11 / $1,027.99 / $1,027.99