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Arizona rates for HCPCS L3916

Wrist-hand orthosis (WHO), includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.56 / $290.07 / $513.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.39 / $456.59 / $825.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.98 / $421.30 / $574.03
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 / $675.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.09 / $381.38 / $2,714.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.52 / $259.77 / $407.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.52 / $259.77 / $407.54