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Indiana 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
Facility
Modifier
Low / Median / High Price
$288.50 / $288.50 / $582.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.39 / $293.91 / $313.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.48 / $521.67 / $582.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.93 / $325.80 / $458.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.55 / $641.16 / $874.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.45 / $641.16 / $786.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $582.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $237.52 / $597.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.18 / $288.39 / $429.41