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Arizona rates for HCPCS L3906

Wrist-hand orthosis (WHO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $275.42 / $1,318.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $416.87 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $363.08 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $588.84 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $295.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $389.05 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $218.78 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $281.84 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $218.78 / $331.13