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Minnesota 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 / $755.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.00 / $679.77 / $799.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.19 / $1,160.67 / $1,528.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$869.93 / $1,033.04 / $1,087.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $3,355.05 / $9,318.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,260.75 / $1,336.40 / $1,601.15
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,991.85 / $3,219.00 / $7,337.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,260.75 / $1,260.75 / $1,297.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.88 / $1,087.41 / $5,063.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.08 / $538.04 / $1,186.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.08 / $484.64 / $1,091.95