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Oregon rates for HCPCS L3915

Wrist Hand Orthosis Includes One Or More Non- Torsion Joint(S) Elastic Bands Turnblocks May Include Soft Interface Straps Prefabricated Itemthat Has Been Trimmed Bent Molded Assembled Orotherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.67 / $341.27 / $1,641.41
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 / $237.52 / $325.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.23 / $1,102.97 / $1,438.54
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.27 / $484.94 / $568.90
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.00 / $534.77 / $597.35
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.58 / $568.90 / $625.79
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.01 / $568.90 / $589.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $498.15 / $597.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $498.15 / $625.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$473.98 / $946.06 / $1,995.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.25 / $625.79 / $625.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.20 / $259.77 / $495.62