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New Hampshire 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
$288.40 / $346.74 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $281.84 / $407.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $562.34 / $645.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $295.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $794.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $223.87 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $257.04 / $457.09
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $741.31