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New Hampshire rates for HCPCS L3905

Wrist Hand Orthosis 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
$597.63 / $597.63 / $717.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.81 / $463.74 / $644.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.39 / $1,061.39 / $1,258.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.99 / $635.91 / $635.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.01 / $607.01 / $607.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.12 / $607.01 / $860.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.34 / $859.34 / $2,652.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.00 / $529.51 / $628.74
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.94 / $874.43 / $1,112.92