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New Hampshire rates for HCPCS L3915

Wrist-hand orthosis (WHO), includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$320.33 / $320.33 / $384.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.13 / $248.57 / $320.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.90 / $568.90 / $674.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.64 / $316.64 / $332.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $325.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $325.37 / $465.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.61 / $460.61 / $1,421.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.46 / $283.82 / $460.61
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.69 / $408.86 / $520.37