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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
$558.91 / $558.91 / $558.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.81 / $558.91 / $869.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,299.03 / $2,197.73 / $9,356.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.08 / $826.43 / $826.43
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
$443.12 / $726.59 / $1,101.06
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.00 / $1,174.00 / $1,370.00
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
$1,413.63 / $1,413.63 / $1,413.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.41 / $525.57 / $926.73