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Wisconsin rates for HCPCS L3908

Wrist Hand Orthosis Wrist Extension Control Cock-Up Non-Molded Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.86 / $51.26 / $92.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $42.50 / $118.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.39 / $88.43 / $146.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.28 / $74.76 / $98.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.83 / $88.43 / $172.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.39 / $84.41 / $92.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.70 / $166.03 / $335.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.36 / $133.88 / $152.15
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.28 / $60.43 / $92.45
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.04 / $80.39 / $96.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.28 / $80.39 / $358.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.03 / $40.61 / $87.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.86 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.28 / $60.84 / $92.45
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.04 / $80.39 / $96.47
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.39 / $120.59 / $197.73
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.70 / $157.02 / $358.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.36 / $45.70 / $506.84
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.39 / $80.39 / $80.39
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.20 / $80.39 / $80.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.74 / $40.11 / $76.88