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Illinois 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
$562.34 / $562.34 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $562.34 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $2,089.30 / $7,585.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $1,202.26
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,412.54
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $870.96 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $537.03 / $831.76