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Virginia 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
$524.78 / $524.78 / $1,292.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.40 / $524.78 / $621.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.39 / $1,061.39 / $1,127.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.91 / $635.91 / $781.92
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.71 / $645.71 / $725.56
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 / $443.12 / $834.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.97 / $955.25 / $1,273.67
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.88 / $593.00 / $1,185.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.03 / $1,326.74 / $1,767.92
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.50 / $815.96 / $1,329.01
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.50 / $815.96 / $1,329.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.90 / $529.51 / $796.04