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Indiana 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
$538.21 / $538.21 / $1,087.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.51 / $548.33 / $584.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$859.05 / $973.23 / $1,087.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.48 / $635.91 / $858.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$820.01 / $1,196.15 / $1,631.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.30 / $1,196.15 / $1,468.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $607.01 / $1,087.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.12 / $607.01 / $1,115.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.08 / $518.32 / $730.04