go back

Utah 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
$140.30 / $187.20 / $236.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.30 / $261.63 / $1,335.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.31 / $293.31 / $293.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.12 / $372.62 / $447.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.05 / $329.12 / $427.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.76 / $440.26 / $440.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.70 / $315.58 / $473.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.16 / $217.32 / $278.26